Is There Any Such Thing As ‘Safe Starches’ On A Low-Carb Diet?

I’ve literally heard it all over the past eight years of dedicating my life to promoting healthy low-carb living that rarely am I ever surprised anymore by any dietary concept that I am introduced to that supposedly improves upon the high-fat, moderate protein, low-carb nutritional approach that is right for me. It’s important to discover what works for you and your individualized situation because it’s far too easy to get sidetracked by information that floats around out there in the blogosphere. I’m all for staying on top of the latest cutting-edge information about healthy eating, but it’s gotta make sense for me or I have a difficult time embracing the change. Such is a concept that has gained traction this year to the worrisome concern of many of my readers.

Following my March 2011 podcast interview with a man named Paul Jaminet, author of The Perfect Health Diet, there has been a steadily increasing amount of concern from low-carbers writing to me about whether he is on to something with what he describes in his book and blog as “safe starches”–namely white rice, white potatoes, yams and more. Say what?! Wait wait wait, NOW starches are GOOD for you and can even be deemed as “safe” for people who are obese, diabetic or otherwise metabolically compromised in some way? The reasoning behind this I gotta hear.

For those of you unfamiliar with who Paul Jaminet is, he is an astrophysicist at the Harvard-Smithsonian Center for Astrophysics and was able to beat a chronic health issue in his life by using the strategies implored in The Perfect Health Diet. His wife Shou-Ching Shih Jaminet, who co-authored the book with Paul, is a molecular biologist and cancer researcher at Beth Israel Deaconess Medical Center and Harvard Medical School. They have combined their efforts to educate the masses about what they have learned about human nutrition through their web site PerfectHealthDiet.com (in fact, you’ll see I have Jaminet’s blog listed on the right-hand side of my blog in “The Best Blogs” section). I am not one to just throw the baby out with the bathwater when it comes to those who offer up an alternative hypothesis to what I believe is true, especially when it comes to nutrition. But it’s gonna take a whole lot of convincing, scientific evidence and massive amounts of n=1 stories of people finding success eating white rice, white potatoes, and the like to get me to buy into this notion of “safe starches.”

To describe this concept of “safe starches” as controversial is a massive understatement. So many of my fellow low-carbers view the idea of purposely consuming starchy foods on a regular basis as blasphemy. You know, it kinda defeats the purpose of consuming a carbohydrate-restricted diet for the benefits of controlling blood sugar/insulin levels, right? Dr. Atkins has got to be turning over in his grave at the very thought of reintroducing a food into a low-carb diet as “safe” when all indicators show it is anything but. However, this “safe starches” concept has caught on among many of the most prominent members of the Paleo community this year, namely people like Dr. Kurt Harris, Robb Wolf, Chris Kresser, and Diane Sanfilippo, for example. And Jaminet is right there in the thick of it actively promoting the consumption of foods like white rice, white potatoes, taro, plantains, etc. through his own graphical representation of what he promotes as The Perfect Health Diet:

My primary concern with what Jaminet has come up with here is this promotion of starches as something that is “safe.” In a perfect world where the modern-day food system hasn’t been compromised, consumption of unnatural additives and chemicals in foods isn’t the norm, and obesity, diabetes and chronic disease is virtually nil, then perhaps there would be merit to the idea of “safe starches.” But for anyone who has been morbidly obese like I was once weighing in at over 400 pounds, diabetic with heart disease like my brother Kevin was, or dealing with a whole myriad of other cardiometabolic health issues, I think it is potentially dangerous to give people like this a virtual green light to consume these foods they hear are “safe” for them to eat. How can someone who is metabolically-deranged consume a food that will spike their blood sugar and insulin levels and consider that anything close to being “safe” for the their health? If you give people permission to eat these starches by calling them “safe,” then it can give the false impression that there will be no consequences on their weight and health. Unfortunately, that’s just not the case for everyone.

It all goes back to livin’ la vida low-carb 101. One of the basic principles of the healthy low-carb lifestyle is cutting down on starch and sugar as a means for controlling blood sugar spikes and the associated increase in insulin. When you consume starchy foods like rice or potatoes, your body breaks them down into simple sugar (glucose) which then raises blood glucose leading to an insulin response to deal with it. An overabundance of sugar in the blood (whether consumed directly or if the body converts starch into sugar) that goes beyond the needs for energy will then become stored body fat. This is why low-carb diets have worked for so many of us because we’ve come off the blood sugar roller coaster once and for all.

This is why controlling starch consumption is essential to lowering body fat, increasing insulin sensitivity, improving cardiovascular health through improved lipids (namely higher HDL, lower triglycerides and less small LDL particles) along with positively impacting various other metabolic health markers. Plus, consuming more carbohydrates in your diet pulls you away from using fat for fuel to a greater reliance on using carbohydrate for fuel in your body. If you’ve been low-carbing for any length of time, then you know how difficult those few weeks of transitioning from a carb/sugar burner to a fat burner can be. Why would you want to go through all of that yet again just because somebody labels an off limits food as “safe” to eat? Incidentally, I plan on testing this “safe starches” concept on myself in and upcoming n=1 blood sugar testing experiment.

It really all boils down to this for me: Why does Jaminet advocate for the consumption of what he describes as “safe starches” when everything about what we seem to know about these foods indicates they are anything but “safe” for most of the population that is metabolically damaged in some form or fashion? I felt this question was far too important for me to ignore any longer because it goes to the very heart of why I support low-carb nutrition for most people to begin with. In my search for answers, I personally contacted many of my fellow low-carb/Paleo expert friends to have them chime in with their thoughts about this idea of “safe starches.” An e-mail from one of my readers was the inspiration for me sending the following out to a wide variety of medical professionals, researchers and nutrition experts for a response:

Several places in the book and on Jaminet’s blog he specifically warns against the danger of a very low-carb diet (defined as less than about 300-400 calories per day (~100 grams) from so-called “safe starches”–taro, plantains, yams, white potatoes, sweet potatoes, white rice and berries) because less than this leads to the risks, including:

1) “insufficient production of mucus in the digestive tract” leading to dysbiosis 2) vitamin deficiencies (he particularly mentions Vitamin C and glutathione on pages 253-254)

In particular he emphasizes these calories need to come from “safe starches and berrries” and “don’t count vegetables as as a carb source (because) they are a fiber (and therefore a fat) source” (page 45).

A recent post he wrote for cancer patients revealed his recommendion of obtaining 400 to 600 glucose calories a day, mainly from these safe starches. He says it is important to avoid a glucose deficiency, since glycosylated proteins are the means of intercellular coordination, and defects in glycosylation are characteristic of the cancer phenotype. He notes, “You don’t want to aggravate this with a self-induced glucose deficiency.”

I’d like to write a blog post about this topic of “safe starches” to help my readers understand fact from fiction and will quote from your response. THANK YOU! If you cannot assist me, then please let me know so I ask someone else to contribute.

I knew I’d get a strong response, but this was even more overwhelming than I could have ever expected. It was gratifying to hear back from so many in both the low-carb and Paleo communities who had very solid opinions about what they thought about “safe starches” so there would be no ambiguity about it. I’m listing all the comments in random order as they were submitted back to me. Get ready to absorb a whole lot of information on a subject that is critical if you are seeking optimal health and weight loss in the body you’ve been given. ENJOY!

The Atkins program is specifically formulated to minimize the impact of carbohydrates on a person’s blood sugar level because elevated blood sugar and the resulting excess insulin production can inhibit weight loss, weight management and increase the risk of disease and illness. We accomplish this by understanding that not all carbohydrates behave the same way in a person’s body. While most carbohydrates – sugar, which imparts 4 calories per gram, is the best example – are digested by your body and turned into blood sugar very quickly, other carbohydrates behave differently. Some carbs, such as vegetables have the least impact on blood sugar. And, some carbs – such as fiber – can impart as little as 0 calories per gram, are not digested at all and pass through your body as waste. Any way you look at it, if an individual is trying to gain the Atkins Edge of fat burning, consuming high glycemic carbohydrates such as rice or potatoes will throw them back into a glucose metabolism thus throwing them out of fat burning.

These “safe carb” recommendations are based on a glucose metabolism mentality and hypothesis. If your energy supply is coming from carbohydrates, which turn to glucose in the blood, there maybe some truth we can squeeze from these assumptions. However, when you burn fat for energy, the story is quite different. The brain and every cell in the body use glucose and ketones for fuel very efficiently. In fact, ketone experts say the body functions more efficiently on ketones especially when glucose metabolism is broken. Moreover, glucose is tightly regulated and there is never a deficiency of glucose on Atkins because glucose is formed from substrates such as gluconeogenesis. Paul Jaminet’s guidelines also do not take into consideration genetic differences, age, gender, activity level, medication usage and individual metabolism. These factors must be considered when finding the program that will assist you to improve or maintain health as you age.

This is also the first time I have ever heard that glycation can be good for you. Researchers have suggested that spikes in blood sugar can in fact accelerate the aging process. Glucose can react with proteins and nucleic acids (the building blocks of proteins) to form new structure, known as advanced glycosylation endproducts (or AGE). AGE, appropriately named, are believed to be involved in the aging process. Over time, AGE can cause connective tissues to lose strength and elasticity, resulting in skin sagging. In other words, wrinkles will develop with AGE, as well as with age! This is also why Diabetics have so much inflammation and organ failure over time. By avoiding spikes in blood sugar with a diet that regulates blood sugar response with foods that are low glycemic, you can slow down the formation of AGE. With less AGE, you will have less wrinkles, less inflammation, and you’ll continue to look and feel your age (or even younger if you consider the other great health benefits you experience when you follow a healthy lifestyle).

CHRIS MASTERJOHN, PHD CANDIDATE IN NUTRITIONAL SCIENCES As a broad general principle, I support what the Jaminets have written about glucose requirements, except to add that I find it unlikely there is any particular optimal macronutrient ratio that applies to everyone. Their argument as I understand it is that the body has a physiological need for glucose. This is true. The need for glucose can be reduced on a ketogenic diet, but it cannot be eliminated. The body can make glucose from protein, so the physiological need for glucose does not mean there is a dietary need for glucose.

That said, some people might be better at making glucose from protein than others, and some adverse circumstances may compromise an individual’s ability to make glucose from protein. Thus a “safe bet” would be to meet the minimal glucose requirement with glucose rather than with protein. Ultimately, however, one needs to determine one’s own responses to diet, because everyone is a little different. So I think the Jaminets provide a good starting point by attempting to identify the most “probable” ideal ratio, but a starting point is a just a starting point. Find what works for you.

DR. KURT HARRIS FROM THE “ARCHEVORE” BLOG I also have come to see most starchy plant organs as perfectly legitimate fuel sources. Low-carb plans have helped people lose fat by reducing food reward from white flour and excess sugar and maybe linoleic acid. This is by accident as it happens that most of the “carbs” in our diet are coming in the form of manufactured and processed items that are simply not real food. Low-carb does not work for most people via effects on blood sugar or insulin “locking away” fat. Insulin is necessary to store fat, but is not the main hormone regulating fat storage. That would be leptin.

My reading of the anthropology and ethnology literature, as well as my current understanding of biochemistry and metabolism, lead me to see the human metabolism as a multi-fuel stove, equally capable of burning either glucose or fatty acids at the cellular level depending on the organ, the task and the diet, and equally capable of depending on either animal fats or starches from plants as our dietary fuel source, depending on the biome (biological environment) we find ourselves born in or that we migrate to. We are a highly adaptable species. It is not plausible that carbohydrates as a class of macronutrient are toxic.

Diabetics need to avoid high carbohydrate intake the same way those with gall bladder disease need to avoid fat, but carbohydrates do not cause obesity or diabetes and fat consumption does not cause gall bladder disease (in fact low fat diets may contribute to gallstone formation via stasis). My list of “safe starches” is white potatoes, sweet potatoes, white rice and bananas. If more exotic fare like plantains and taro is available to you, that is fine, too. Except for white rice, these are all whole food starch sources with good mineral and micronutrient content that have been eaten in good health for thousands of years in many environments by genetically diverse populations.

These starchy plant organs or vegetables are like night and day compared to most cereal grains, particularly wheat. One can eat more than half of calories from these safe starches without the risk of disease from phytates and mineral deficiencies one would have from relying on grains.

White rice is kind of a special case. It lacks the nutrients of root vegetables and starchy fruits like plantain and banana, but is good in reasonable quantities as it is a very benign grain that is easy to digest and gluten-free. I think consumption of quality animal products is the sine qua non of a healthy diet. Once you have that, then eating starchy plants is actually more important than eating colorful leafy greens – the veggies that are high fiber and low starch. Primitive populations practicing horticulture or hunting and gathering do not eat big green salads with lots of variety, but they do eat healthy starchy plant organs with monotony on top of their foraged animal foods.

I now view eating a very low-carb (VLC) diet for a period of time can be a good fat loss maneuver, acting via the effects of ketosis on appetite suppression. I also like to see people limit themselves to two or three meals a day with absolutely no snacking, and it may give benefits via hormesis for longer periods of fasting (24 hours or more) once in a while. But a long term VLC ketogenic diet is not a good idea. It does not mimic the ancestral diet in general, even if some populations have tolerated it when they had to.

There is no need for most people to do it to lose fat, as food reward effects are more powerful. I would advocate long term ketosis in those with neurodegenerative brains diseases like Alzheimer dementia and Parkinson disease and a 10-day water fast followed by long term ketogenic diet is worth trying if you have cancer. But I would not recommend VLC ketosis as a long term way of life the way I would not recommend running a half marathon every day, or lifting weights to failure on a daily basis, or taking chemotherapy drugs when you don’t have cancer. Ketosis probably stresses the body and works via hormesis. The clean up and repair response cannot happen if there is no rest from it.

My arguments are based more on ethnography and anthropology than some of Paul’s theorizing, but I arrive at pretty much the same place that he does. I personally eat around 30% carbohydrate now and have not gained an ounce from when I ate 10-15% (and I have eaten as high as 40% for over a year). If anything I think even wider ranges of carbohydrate intake are healthy. One can probably eat over 50% of calories from starchy plant organs as long as the animal foods you eat are of high quality and micronutrient content.

DR. JONNY BOWDEN, HEALTH BLOGGER AND BESTSELLING AUTHOR I remember skimming through the book and thinking it was pretty good but not going into many details. I think this subject deserves a little time and investigation and I just can’t take any time out to look into it right now. If I had the info on the top of my head I’d be happy to comment, but I’d want to be more sure of what I’m talking about before going on the record.

One thing I can tell you from the research I’m reading for my new cholesterol book–the ONE thing those “starches” have going for them that OUR high-sugar diet does not, is that those starches contain virtually no fructose. So while they may still impact blood sugar unfavorably, they do not necessarily do the metabolic harm that regular sugar (50/50 glucose fructose) or HFCS (same basic thing, slightly different percentages) do.

I have absolutely no idea where he got the mucous thing from, and I can’t see in a million years how you would have a vitamin C “deficiency” if you ate berries, etc. But again, I’d want to read more before commenting too decisively.

DR. ROBERT SU, MD, FROM “CARBOHYDRATES CAN KILL” For a long time, we had falsely believed that carbohydrate was our best energy source because it neither was greasy nor caused us fat, and that we could not live without it. Now, we know that carbohydrate can harm our health and develop diseases such as morbid obesity, diabetes mellitus, cardiovascular diseases, cancer, Alzheimer’s disease, and many more. Dr. Su recommends you read his column “Is There Essential Carbohydrate?” for more information.

TOM NAUGHTON, FILMMAKER BEHIND THE DOCUMENTARY FAT HEAD I can’t answer the question because I don’t actually exist. My pre-agricultural ancestors in Ireland didn’t have access to rice, white potatoes, sweet potatoes, yams, or plantains — and certainly didn’t have access to safe starches of any kind for much of the year — so they became extinct due to vitamin C and glucose deficiencies thousands of years before I was born.

If I did actually exist, I’d reply that a limit of 400-600 calories per day from starches — 100 to 150 grams of carbohydrates — would be a vast improvement over the carb-heavy, grain-heavy diets most Americans consume, so I certainly wouldn’t oppose that diet plan for most people. I consumed around 100 grams of carbohydrates per day during my fast-food diet and still lost weight. However, I’m leaner and healthier now, and I don’t consume safe starches, unsafe starches, reckless starches, highly cautious starches, or any other starches except on very rare occasions. Despite that, my glucose level is usually around 90 to 100 mg/dl. If I eat a white potato, it shoots up to 175 or so and stays elevated for two hours or more. That doesn’t sound like a safe starch to me.

DR. RICHARD FEINMAN FROM THE NUTRITION & METABOLISM SOCIETY Yes. Great dangers here. I remember at the Ancestral Health Symposium where people were dropping like flies. The only part worth considering is the remark about glycosylated proteins. The normal processing of many types of proteins involves the enzymatic addition of molecules of carbohydrate, sugars or what are called glycosaminoglycans (sugar amines). This is an important part of biochemistry but completely different from the non-enzymatic non-specific glycosylation of proteins which occurs due to excess of blood glucose and which is measure, for example, as hemoglobin A1c. The former is part of normal metabolism and is necessary for the normal function of those proteins. The non-specific glycosylation is not normal and impairs the function of the glycosylated protein.

DR. LOREN CORDAIN, AUTHOR OF THE PALEO DIET I am unfamilar with Jaminet’s book, but anyone who advocates eating white rice and potatoes obviously is unaware of the concept of either glycemic index or glycemic load which is unfathomable for any contemporary nutritionist who reads the literature. Yams, sweet potatoes, plantains and berries are healthful carb sources that most people can eat without a problem. The only exceptions would be obese or insulin resistant disease patients

So is the claim that carbs that come from vegetables “don’t count” because they are a “fiber (and therefore a fat) source.” What kind of hooey is that? 4 cups of fresh spinach — enough for a nice big salad — have 4 grams of carb, three of them fiber, and only the merest trace of fat. Going with a carbier vegetable, the average onion has 9 grams of carb with 2 grams of fiber, and still only a trace of fat. That this guy somehow equates vegetable fiber with fat is sufficient to make me question anything else he has to say. It’s also silly to suggest that carbs from vegetables somehow don’t count. A molecule of glucose is a molecule of glucose, regardless of the source. Your cells have no way of knowing if that glucose came from rice or from a salad — or, for that matter, if it was manufactured in the liver via gluconeogenesis.

I admit to not being up on my glycosylated proteins, but again, my handy glucometer makes it quite clear that my low carb diet has not induced any sort of glucose deficiency. I am not particularly excited about the whole “production of mucus in the digestive tract” thing. Dr. Mike Eades points out that apparently the gut secretes mucus when irritated, perhaps in an effort to get the irritant to move on down the line. This does not mean that deliberately irritating the gut is a good idea.

I am *very* clear on the dangers of high blood sugar. I know from testing that a cup of rice will drive my blood sugar over 180. Back in my low fat days, baked potatoes were a staple for me, but all they ever did was make me hungry, a clear sign that they, too, were jacking my blood sugar around. For those who have a robust carbohydrate metabolism, sweet potatoes and plantains seem like good foods. Potatoes and taro, both toxic eaten raw, strike me as iffier. Don’t get me started on rice. Berries, of course, are a fine, fine food.

I wonder, though, why he limits his root vegetables? What does he have against turnips, rutabaga, Jerusalem artichokes, jicama — all of which, unlike his toxic-when-raw “safe” starches are perfectly edible raw? Indeed, I don’t know why he considers these starches “safe.” A search of his website turned up no explanation.

ANONYMOUS PROMINENT MEMBER OF THE LOW-CARB COMMUNITY Jaminet is not a clinician seeing patients and he’s never been obese. In that sense, he’s a theorist. His background isn’t in medicine, and it’s his Harvard affiliation that gives him cache. Like many bloggers in the field, he knows what worked for him and that his informed his opinions.

Now here’s the issue: if he was treating obese individuals or type 2 diabetics, he might find out that 600 calories of glucose a day is too much for weight loss. He might also find out that some people have to go far below 300 to 400 calories a day to lose weight. He might find that safe starches and berries aren’t “safe” for some, even if they are “safe” for others. Or maybe not. But the key is to make a prescription based on what works for you is always a bad idea. What he did, though, is cut carbs considerably and then, in effect, add them back to deal with problems from eating so few.

Compare Jaminet, say, to people like Dr. Steve Phinney, Dr. Jeff Volek and Dr. Eric Westman who have spent their lives working on this in the clinic and the laboratory would give different explanations for all that Jaminet is describing.

So my main point is this: telling people they have to eat or should eat 600 calories of carbohydrate a day based on “book learn’n” is maybe not the best idea.

“CHOLESTEROL MYTHS” PHYSICIAN/RESEARCHER DR. UFFE RAVNSKOV This is nonsense. We are able to synthesize glucose ourselves. How have the Inuits, the Sami people of Northern Scandinavia and the Masai people been able to survive? They live almost entirely of animal food. Ask him for the scientific studies that support his ideas.

ADELE HITE FROM THE “HEALTHY NATION COALITION” Let me begin by saying that I have not read the book, so I’m not sure I’m qualified to comment. However, their overall approach is very reasonable: whole foods with no grains and sugar. Hard to argue with that. Otherwise, and with all due respect to Drs. Jaminet, whom I think have provided an approach to diet that may be useful to many people, here are my thoughts:

1) regarding mucus: I’m sure you’ve seen Mike Eades’ commentary regarding the production of mucus in the digestive tract?

I’m not sure what I could add to this, as this is a very accurate depiction of the physiology of the digestive tract. In short, if you are consuming an excess amount of glucose, the overgrowth of the bacteria who feed on it, plus the irritating effects of the fiber that may accompany it, may very well warrant the production of mucus. How much is excess? That’s a personal variable, but the liver–unless damaged or dysfunctional–is very good at fine-tuning the amounts we need. Anything that disrupts that regulation to a significant extent could be considered excessive, again, a personal matter.

2) Vitamin C? Glucose and vitamin C compete for the same receptor in the intestines. I’m not sure how increasing your consumption of glucose is going to assist your absorption of vitamin C, but maybe this is in the book. Given a sufficient intake of essential amino acids, your body makes its own glutathione, so again, I’m not sure how that relates; perhaps the book explains. It’s true that vitamin C and glutathione are important antioxidants, but elevated glucose and insulin are pro-inflammatory states, so if you are consuming glucose in excess (an individual matter, as above) to increase your antioxidant levels, you may be creating the very physiological state that leads to increased oxidative stress.

3) Warburg determined back in the 40s that cancer cells meet their energy needs in large part by fermentation (of glucose). Unless there’s something wrong with your liver, your body is going to produce the basal amounts of glucose necessary for structural needs. Glucose in excess (an individual matter, as above) may simply “feed” cancerous cells, although the jury is still out on this.

In the end, there’s no such thing as “perfect health”–I’m not even sure there’s such a thing as “optimal health” as the conditions under which we experience health change constantly with environment, age, and activities. The body is in a constant state of damage and repair, cell proliferation and cell death. We should pay attention to how our food makes us feel and act, short term and long term.

Bottom line: Starches are not essential; it is arguable (as is clear from this discussion) as to whether or not they are beneficial. For a person already experiencing metabolic dysregulation related to glucose/insulin issues (obesity, diabetes, inflammatory conditions), I would recommend proceeding with caution. Even a “safe” starch is not safe if it negatively impacts eating and activity patterns; that is what matters in the long run. My biggest concerns would be protein and appetite/activity regulation.

I am not convinced that 50g (200 kcals) of protein would be sufficient for most people’s physiological needs (adequate protein is also a key aspect of appetite regulation), and I would be concerned that–for some–these starches may increase appetite and/or fatigue. For those who are not self-aware enough to recognize a tendency toward “carb addiction,” these “safe” starches may become a justification to indulge in the drug of choice (and let’s be honest, if we’re “addicted” we are always looking for these justifications). That would be like telling someone with an alcohol addiction that wine is “safe” because it has antioxidants.

So folks taking this approach should monitor two things: Are those “safe starches” taking up protein space on my plate? Also, how are these “safe starches” affecting my appetite and my energy levels? It may be a fine approach for some folks, but not for everyone.

DR. LARRY MCCLEARY, AUTHOR OF FEED YOUR BRAIN LOSE YOUR BELLY First, I read his linked reference about defects in O-glycosylation that he listed in his blog (regarding cancer and dysbiosis) as supporting his recommendations for adding carbs as a source of glucose to reduce the impact of an O-glycosylation defect.

If you read the paper you see that O-glycosylation defects have been associated with the cancer phenotype and alterations in mucin production in the gut. They are important for mucin production and he mentions that. However, that paper is more about scientific findings that suggest that the quartenary structure of glycosylation enzyme complexes are much more efficient than activity of the same unassociated enymes. I’m not sure what this has to do with his recommendation to avoid a glucose (and ? hence glycosylation) deficiency by consuming large amounts of glucose. If anything, this type of diet can enhance HbA1c which is glycosylated hemoglobin!

As you well know, when an enzyme acts on a substrate (such as an enzyme that adds a sugar molecule to an enzyme side chain — as discussed in his reference) the pathway involves the action of an enzyme on a substrate (here the sugar molecule). The defects in glycosylation that the researchers are referring to involve decreases in enzyme activity, not deficiencies in available substrate (such as glucose). Usually in biological reactions of this type there are literally billions of sugar molecules available, so lack of substrate is rarely an issue. The main problem is inactivity of the enzyme itself, which is not impacted by how much sugar is available. So suggesting that we eat high glucose to avoid a glycosylation problem doesn’t have any scientific validity, in my opinion.

The other issue I have is I don’t understand what he means by “safe” starch. Is this resistant starch? If so, the % of resistant starch in most carbohydrates is less than 10% of total starch. So to get a little naturally occurring resistant starch, you need to eat a lot of regular starch. The consumption of manufactured resistant starch, free of regular starch, could have benefit because it passes through the small bowel undigested and is fermented by gut bacteria with the generation of healthy short-chain fatty acids such as butyrate.

So, I don’t think you can’t call veggies carbs because they might contain a little fermentable fiber (?safe starch) because the % is small and they contain a lot of other carbohydrate. If they contain sufficient fiber to slow absorption and digestion, then the veggie will have minimal impact on insulin, which is good but is not really related to “safe starch.”

Also, eating this much glucose one could argue is bad for someone with cancer because most cancers are easily identified on PET scans because of their extremely high metabolic rate of glucose use. Dr. Tom Seyfried (at Boston College) has even recommended a low-carb diet for a number of patients with brain cancers and has had some success with this approach (and has published it, as have others). When he puts these patients on low-carb diets the PET scan findings improve (reflecting less tumor metabolism and growth).

CHRIS KRESSER, ACUPUNCTURIST, POPULAR HEALTH BLOGGER AND PODCASTER I see a fair number of patients in my practice struggling with symptoms like hair loss, cold hands and feet, plateaued weight loss, low energy and mood imbalances after following a VLC diet for several months. In many cases they adopted this approach to lose weight, which was successful – at least to a certain point. However, others were not overweight to begin with and simply chose to eat VLC because they got the impression that “carbs are bad”, even for people without metabolic problems. I believe many of these issues are related to the decrease in thyroid hormone levels seen on VLC diets.

In cases where there is no significant metabolic damage, when I have these folks increase their carbohydrate intake (with starch like tubers and white rice, and fruit) to closer to 150g a day, they almost always feel better. Their hair loss stops, their body temperature increases and their mood and energy improves.

For people that are overweight and are insulin/leptin resistant, it’s a bit trickier. In some cases increasing carbohydrate intake moderately, to approximately 100g per day, actually re-starts the weight loss again. In other cases, any increase in carbohydrate intake – in any form – will cause weight gain and other unpleasant symptoms. A different approach is required for these patients.

As always, there’s no simple answer and no one-size-fits-all approach. If I could leave your readers with one point, that would be it.

DR. DAVID DIAMOND, NEUROSCIENTIST AT THE UNIVERSITY OF SOUTH FLORIDA I’ve checked out Paul Jaminet’s blog, and I think his advice, in general, is good. He emphasizes a diet that’s 50-70% of calories from fat, which is good, and, in general, I agree with his fat/protein/carb recommendations, which include limiting PUFAs, cereals, legumes and, of course, refined sugar. His recommendation of 400-600 calories (100-150 gm) from carbs/day does fit with a relatively low carb lifestyle and can contribute to stable weight or weight loss, depending on the individual’s metabolism, activity, etc. This has been my basic diet plan for the past 6 years and my blood lipids have responded in the right directions and I’ve lost about 25 lbs (although I do try to keep my carbs closer to 100 g/day).

However, his warning about slipping to 300-400 calories of carbs/day as unhealthy just doesn’t make sense. The Inuit, as well as white Arctic explorers (e.g., Stefansson), thrived on diets that are very low in carbs. I know of no evidence that there is any requirement for carbs in the diet whatsoever. As to vitamin C deficiency, scurvy was found in populations that ate simple carbs w/o fruit (e.g., sailors), but not in populations that didn’t consume simple carbs. That is, there’s no scurvy found in the Inuit or Maasai, despite the fact that they don’t eat obvious sources of C, such as fruit. Although people can’t produce C, they probably recycle C, which keeps them from getting scurvy as long as there isn’t much glucose around to interfere with C transport and recycling.

I’ve seen a lot of commentary on low carb diet and hypothyroidism, but so far everything I’ve seen has been on measures of biomarkers, such as LDL, but I haven’t actually seen adverse health outcomes for most people who eat 50-100 gm of carbs/day. Of course, if you’re a marathon runner or some other endurance athlete, perhaps carbs would be a better source of energy than ketones.

As to cancer, his recommendations to eat 400-600 calories from glucose make no sense. Cancer cells have a powerful craving for sugar. Their mitochondria are impaired at utilizing ketones and, instead, cancer cells have an incredibly high metabolic rate and utilization of glucose. Cancer tissue has the highest density of insulin receptors in the body, so why would anyone want to elevate their blood glucose just to feed their cancer cells? Ketosis is not a cure for cancer simply because gluconeogenesis from proteins will maintain blood glucose levels in a normal range, which will fuel the cancer cells even when glucose is not consumed. Still, maintaining stable and low blood glucose has been shown to reduce cancer growth in animals and there are positive effects in people, as well (see work of Thomas Seyfried, Boston College). I do agree with Jaminet’s recommendation that you become ketotic before getting chemo, but I would further recommend that one should remain in ketosis until the cancer is gone. Watch Dr. Diamond’s video presentation on diet for more information.

LIVIN’ LA VIDA LOW-CARB BLOG READER RESPONDING TO DR. HARRIS I follow your blog as well as a great many others on low-carb/paleo/etc. I just saw Kurt’s item on safe starches as a response to you. I have some serious concerns about this idea of safe starches without significant qualification. For those who are pre-diabetic or have a family history of diabetes then I would suggest that so-called “safe starches” are not safe and are quite dangerous.

I have attached a chart (hope you can see it) I produced as a result of my own experiments on myself. I had been attempting to introduce more carbs into my VLC regime, after reading the “Perfect Health Diet”, and sweet potatoes seemed like a good start. But my blood sugar readings showed the danger of such polysaccharide nutrients. After 6 hours my blood sugar had not returned to normal – I’d have tested further but that last reading was midnight and I needed to sleep.

For comparison I did the same tests on some Ice-Cream and a high protein/fat meal. I recovered far faster from a full pint of Ben and Jerry (something I do not consider healthy), than the supposed healthy safe starch of a sweet potato. Note that my normal typical meal of something like eggs and liver did not show a significant change in blood sugar. The ice-cream is some 50% fat and the 100g of sugar I suspect are primary monosaccharides, which my body seemed to deal with pretty quickly.

Some background on me: I am 59, I was some 233lbs in 2003 and diagnosed as pre-diabetic (FBS of 125). My doctor suggested I reduce my carb intake so I started looking at Atkins and others. I am now 170lbs (BMI 26), so almost normal, and I am no longer pre-diabetic. So I have lost some 63lbs, although I did reach 160lbs earlier in the year, before I started trying to introduce some so called safe starches. I reached this point with a nearly zero-carb regimen – pretty much any carbs for me stalls weight loss, even milk or cheese is disastrous. My mother is diabetic and so were her sisters and their mother – it is very much a family trait. My mother is 95 – so I have longevity in the family. I suspect that with a careful restriction on carbs I should be able to avoid diabetes permanently as I suspect will be the case for other potential pre-diabetics.

My A1c self tested last month was 5.9%. While officially below 7% is considered safe others with greater expertise say it should really be below 5% with 4.5% as an optimum. I am pretty sure that if I adopted these so called safe starches and saw consistent prolonged high glucose levels as I saw in my experiment then my A1c is not going to come down. My family has no history of heart disease. My father at 92 died of the effects of head injuries sustained from WWII – I suspect he would have lasted a lot longer otherwise – he heart was very strong, similarly for my mother.

For me, VLC or near zero-carb works very well, but this trend in the Paleo movement I am seeing for a creeping increase in carbs is a real concern. I suspect that long term those extra carbs and hence higher levels of continuous insulin over decades will turn out to be a negative result.

For those who do not have a genetic diabetes trait then I suspect the higher carb paleo regimen may work fine, but not for those like me. I would like to see all this advice about paleo and so-called safe starches be more carefully qualified so that people like me will not go astray. My pancreas is now likely seriously impaired through decades of high wheat, sugar, and Omega-6 consumption, and I suspect I am very much on the borderline of staying healthy – safe starches are not the way to go.

DR. ANDREAS EENFELDT, SWEDISH PHYSICIAN KNOWN AS “THE DIET DOCTOR” While most people can probably obtain “perfect health” on 400 to 600 calories from “safe starches and berries” a day, some do not. Specifically people with diabetes type 2 and metabolic syndrome generally do better on lower carb intakes. It may also aid weight loss.

Regarding “insufficient mucus” in the intestines I have never heard of this problem. It sounds weird to me, but if there is any good science behind this idea I would certainly take a look at it.

Regarding “glutathione deficiency”: Glutathione is not an essential nutrient, it is produced by our bodies from amino acids i.e. protein. I have never heard of deficiencies of glutathion on low carb diets. My guess is that this idea is controversial at best.

There is no need to eat starchy food for vitamin C. You get plenty from low starch vegetables, so there is no need to eat more than a few grams of carbs to get all the vitamin C you need.

You do not get “glucose deficiency” on strict low carb. The glucose levels in the blood stays within the normal range even on zero carb diets, because of gluconeogenesis and ketosis.

DR. JEFF VOLEK, LOW-CARB DIET RESEARCHER AT UNIVERSITY OF CONNECTICUT Claiming you need carbs to prevent scurvy is a red flag this guy is a nut job. Tell him to eat a red pepper. There is no evidence what so ever the human body has any dietary requirement for the nutrient class of carbohydrate (i.e., there is no defined condition associated with not consuming carbs).

DR. JEFFRY GERBER, AKA “DENVER’S DIET DOCTOR” This sounds like a glycemic index type of diet with the starches added into the mix. To me starch is just a carbohydrate like any other and based on the science of insulin metabolism drives inflammation. I do not know anything about deficiencies and mucus.

The comment about cancer. Patients who are ill such as cancer, post surgical, after the hospital are stressed and their basic metabolic rate is increased. In this situation I have found that there is an increased caloric demand. Patients require more calories from fat protein and carbs.

DR. JACK KRUSE, NASHVILLE, TN-BASED NEUROSURGEON AND BLOGGER I read Kurt and Jaminet’s take. I think these recommendations are madness based upon the totality of the data we have today. I think avoiding anything that stimulates the IGF1 pathway is “smart” based upon current knowledge and i think using a ketogenic diet is also prudent. While i like both of these guys, neither one has any clinical experience treating cancer patients. They read literature. When kurt was a practicing doc he spent time in a dark room with films not patients. I showed our oncologist these comments and they both shook their head. I spent four years getting these guys to come over to evolutionary biology based upon science and now these two primal insiders decide damn be the science?

I think the science is far from worked out but nothing i have read critically reviewed support jaminet’s claims. My personal opinion is this……..the best way to show someone they are wrong is allow them to go down the path they choose and let them learn for themselves. Some people may do the same but when they see their clinicians and the news is not good…….then there testimony will shine sunlight on who’s interpretation of science is correct.

If you remember our podcast……i told you i am wary of authors with books to sell on diets. Here is a perfect example of someone trying to fit their theory into everything. Id rather use evolutionary biology to give us a custom health care plan instead. I wrote a blog on what to do for a new cancer diagnosis–and its completely opposite these recommendations. I guess the new cancer patient will have to choose who is more correct.

Not eating fish oils is just lunacy as he says to get them from oily fish; yet, a can of tuna is 200 calories which is above his recommended daily intake and still only gives you about 500 mg of EPA/dha. This is a really contrived diet and not based on science of any sort that I am aware of. Here are my thoughts about this:

PEOPLE WHO ARE DOING LOW CARB JUST HAVE TO FACE THE FACTS THAT THERE ARE NO SAFE STARCHES. NATURALLY THEY ARE GOING TO WANT TO BELIEVE SOMEONE WHO TELLS THEM THEY CAN EAT POTATOES, RICE, ETC BECAUSE THEY WANT TO EAT THEM. YOU HAVE TO COMMIT TO A LOW CARB LIFESTYLE OR NOT – THERE IS NO ROOM FOR COMPROMISE. ALSO, IN HIS BOOK, 200 CALORIES FROM STARCH WILL TAKE THE AVERAGE PERSON OUT OF KETOSIS SO WHAT IS HE TALKING ABOUT?

DYBIOSIS IS OFTEN CURED BY A LOW CARB DIET. THERE IS NO SCIENCE TO BACK UP THE VITAMIN DEFICIENCY CLAIMS. VEGETABLES ARE CARBOHYDRATES AND TOO MANY OF THEM CAN KNOCK SOMEONE OUT OF KETOSIS ERGO, THEY COUNT AS CARBS. RICE IS NOT A FAT SOURCE EITHER AND NEITHER ARE BERRIES OR POTATO SO WHAT?????

CANCER CELLS FEED PRIMARILY ON GLUCOSE – ANYONE WHO HAS EVER SEEN A PET SCAN KNOWS THAT. YOUR BODY WILL GLYCOSYLATE PROTEINS WITHOUT ANY ADDED SUGAR – IT WILL DERIVE IT FROM ANY FOOD YOU EAT JUST LIKE THE BRAIN; DEFECTS IN COMMUNICATION NOT GLYCOSYLATION ARE CHARACTERISTIC OF CANCER

DR. ERIC WESTMAN, LOW-CARB RESEARCHER AND PRACTITIONER AT DUKE UNIVERSITY I don’t know much about this book. Have there been any studies of this diet book specifically? I doubt it. I’m confused now because I found this at the Jaminet’s web site: Some conditions, such as epilepsy, brain and other cancers, and some mental health and neurological disorders, may benefit from very low-carb ”ketogenic” diets.

I know of no studies to support these assertions about the bad effects of low carbohydrate diets. Our bodies are able to make glucose internally, so this excerpt makes no sense: He says it is important to avoid a glucose deficiency, since glycosylated proteins are the means of intercellular coordination, and defects in glycosylation are characteristic of the cancer phenotype. He notes, “You don’t want to aggravate this with a self-induced glucose deficiency.” I have never heard of a “glucose deficiency” in a relatively healthy individual.

PETER D. FROM THE “HYPERLIPID” BLOG Paul did send me a copy of his book when it came out but I’ve not had time to read it in any detail. He did contribute to the discussion we had on Hyperlipid about the incidence of cancer in OD eating people in Poland, where GI cancers are over represented in the OD (LC) eaters and in the general population too.

I have no real faith in the concept that we might damage our mammalian lectin signalling system (which is very important, I never even got time to start thinking about posts on mammalian lectins, we do in fact use them everywhere, maybe a post there some day) and failed mucus production through glucose deficiency. In particular I can’t see glucose deficiency being a gut problem as this is the organ with the highest exposure to dietary glucose.

We none of us know exactly how little we know. I had no handle on the likelihood of developing cancer on a LC diet until I realised that a) you cannot always normalise blood insulin levels by LC (or even by starvation) and b) this is probably mitochondrial in origin. There are suggestions that cancer may well be a mitochondrial problem. So now I have my own ideas about cancer, insulin, ILGF-1 receptors and the limits on the ability of any given person to normalise insulin… This seems more believable to me.

Safe starches? Yes, if you have a decent population of mitochondria which don’t need to be surrounded by high levels of intra cellular fatty acids to function normally (ie if you are not severely insulin resistant). If you have a poor population of mitochondria to choose to breed from (looking to cure, rather than side step, IR) there may be limits to what you can manage and what starches of any sort you can consume.

If Paul is correct I would like to see the long term outcomes. The OD has been around for decades and its limitations are only just beginning to show.

I have to say I feel Paul’s approach is reasonable for a fair swathe of the population but it will not suit all of us, exactly as applies to the Optimal Diet I eat. I’m sort of loathe to go head-to-head as you then end up like Colpo vs Eades. That is arguing semantics and nit picking. Coplo is a LC-er, he just doesn’t see it as effective for ultra athletes. But 600g/d of carbs for an Iron Man is LC and AC actively suggests that normal LC for sedentary folks is a reasonable idea. Or you end up making the criticisms I have reluctantly had to make of Stephan’s retaliation against Gary Taubes.

Can you heal your mitochondrial population to a level where you can tolerate safe starches? I don’t know and I doubt anyone else knows. In terms of academic research to pick over we are still at the level of LC vs LF, which LC wins most of the time. The occasional success of LF is probably explicable in terms of mitochondrial function too. Perhaps, seems to be anecdote from chronic LC-ers. For some.

So I guess this is a big “I don’t know”, which is probably not a lot of help.

I agree that the starches designated as “safe starches” are indeed safer, i.e., lack inflammatory triggers like gluten, lack the appetite-stimulant gliadin, do not have destructive lectins, etc. However, this quantity of carbohydrate (100 grams per day) exerts variable effects on different individuals, depending on carbohydrate sensitivity.

An established type 2 diabetic, for instance, can have blood sugars of 300 mg/d–very high–after a serving of one of these foods. Someone with pre-diabetes can easily have blood sugars of 200 mg/dl or higher after one of these foods. Recall that, in 2011, type 2 diabetes and pre-diabetes includes the majority of adults around us.

These starch in this quantity also trigger formation of small LDL particles, the most common cause of heart disease and heart attack in the U.S. This is why I advise patients who are susceptible to these effects to limit carbohydrates more towards the range of 50 grams or less per day, 30 grams or less per day if they are already diabetic.

Overall, I believe his diet seems a rational, workable program. I’d be concerned, however, that the quantity of these “safe starches” are likely to lead to an excess triggering of the above patterns and all their consequences.

VALERIE BERKOWITZ, RD WHO BLOGS AT “FOR THE HEALTH OF IT” Dysbiosis was originally introduced by Dr. Eli Metchnikoff in the early 1900s describing an imbalance of the bacteria in the gut. The word comes from ‘symbiosis’ meaning to reside together harmoniously with the ‘dys’ meaning the opposite. Dysbiosis refers to a bacterial imbalance in the gut, which can compromise the immune system. The main causes of Dysbiosis are believed to be antibiotics and pesticides along with other environmental and dietary factors. In other words yeast overgrowth…Yeast loves the sugar in potatoes …the best way to reduce yeast overgrowth (I’ve been doing this as far back as Dr. Atkins) is to restrict simple and total carbs to starve the harmful bacteria and supplement with a probiotic. If you feed the harmful gut bacteria, you can compromise your immune system leading to other illnesses.

Tomatoes are a good source of vitamin C and when cooked the lycopenes help prevent prostate cancer are you gonna avoid them because they are not on the “safe starch” list? Jimmy you have the research on AGE products and insulin like growth factor and cancer. Why is he putting vitamin C and calories together? Vitamins provide nutrition and not calories? I have never heard of a fiber being called a fat and quite frankly omega-3 fats (from free range/grass fed organic meats) can reduce inflammation that can be caused by “safe vegetable starches” omega 6’s.

Cancer cells need glucose to multiply Ketosis helps to starve the cancer cell. You know they are doing research on brain tumors and ketosis. There is no glucose deficiency due to gluconeogenesis which is why starches are not essential. He’s gonna get more glycosylation with potatoes (AGE products) with his diet than he will with my diet and not as many vitamins/minerals.

Seriously someone should report them I guess I feel so strongly because of their use of the word “safe” in such a general and global population when there is no support in most of the claims they make. And especially because with all the research and information out there about spiking blood sugar and heart attacks (even if you do not have diabetes) and all the other associated morbidities and what about the carb cravers, most people who do low carb do so because they are addicts, that could send someone into a tail spin.

The total carbs is lower than someone doing 300 g but in my opinion the choices they encourage defeat the purpose of lowering total carbs because of the spikes and dips in blood sugar that his “safe starches” cause.

DIANE SANFILIPPO, PALEO NUTRITIONIST FROM “BALANCED BITES” I think they make sense in terms of healthy carb sources for those who want/need them for activity or life/food enjoyment as well as for gut motility/feeding beneficial bacteria, though saturated fat can do the same. I still think it’s an individual thing to consider and test out for each of us as well as to play with over time. Perhaps today someone doesn’t do well with much starch, but in 3 months, 6 or a year, they will do perfectly fine with them.

I am wondering if he considers these “safe starches” because they do not have gluten. Some of the ‘toxic’ ones he lists do.

I haven’t heard of dysbiosis or that low carbohydrate intake might lead to mucus problems in the gut. I looked up dysbiosis—now that I know the word, I can say yes, this is a health issue that is discussed and that diet changes can impact the bacterial flora present in the gut. I’m not sure about the mucus.

Fiber is not a fat (if anything it is a sugar), and anyway most vegetables are quite low in fat, not that fat should be shunned.

I don’t think a carbohydrate deficiency exists, much less a glucose deficiency, although severe hypoglycemia (low blood sugar) is a serious health problem. I wouldn’t call that a deficiency in the sense of the way we usually use that word in regard to nutrients.

There are two issues to cover before we can close the door on the starch safety class: 1) Are some carb/sugar sources better for us than others, and 2) do we need to eat any glucose or can we truly make all we need from conversion from proteins

I’ll address the first question first:

Are some carbs safe and some unsafe?

You can apply the same rule to good/bad starches as we can to good/bad fats. In Chapter 8 of Deep Nutrition we explain why “Nature doesn’t make bad fats.” What makes bad fats for us is all the high-temp and chemical processing, which distorts the molecules and generates toxic, self-replicating MegaTrans fats.

The same applies to starches: Nature doesn’t make bad starches. What makes starches bad for us is processing, which, in this case distorts proteins in the starch, rendering them potentially immuno-reactive so we are likely to create antibodies against them and thus to get a variety of inflammatory reactions upon repeated exposure to the same protein.

Food allergies are dramatically on the rise, especially in kids, and it’s not just because of the GMOs. It’s because of the processing and the fact that we eat foods that promote glycation and lipid oxidation, which derange our cell membrane function and make our immune systems go haywire. White blood cells mistake proteins in foods for pathogens, and make antibodies against protein components of food. This could make any food unsafe. But it has to have that protein component. Wheat, soy, corn, all have alot of protein compared to the “safer” starches like potatoes, yams, and rice. When these starchy foods are processed their protein componenets are distorted in such a way as they attract the attention of the immune system and in the background of a diet that causes glycation and lipid oxidation (that is to say, promotes inflammation) the immune system is even more likely to react to proteins in the foods as if they were toxic compounds.

At this point in our history of eating, when we’ve been feeding kids with developing immune systems processed foods containing wheat, corn, barley, soy, and other starches on the “unsafe” list, we’ve created a generation of children with antibodies to the proteins in these common starchy ingredients.

I am about to complete a video I am making on food intolerances and specifically gluten intolerance that will explain why some people have intolerances to these processed foods and not to things like rice, yams, and sweet potatoes—how often have you seen those on the list of ingredients in your cereal? This concept of processing underlying the safety of starches is very important because as manufacturers start using substitutes for consumers with celiac disease, they are simply replacing corn, wheat, and so on with rice, potato, yam etc, and these currently safe starches may soon become less safe. The good news is, rice, potato and yam have less protein and so they are also less likely to trigger an antibody reaction than the higher protein starches they are replacing.

Do we need to eat any sugars or can we make all we need from proteins?

There is research to support the idea that our bodies need some sugars, xylose for instance, that our enzymes cant manufacture. However we are likely to get these from vegetables, mushrooms and micro-organisms in our intestines can, so as long as we have a balanced diet and healthy gut flora, we should be just fine.

The Jaminet’s assertion that we need to eat at least 100gm per day of carb is based on the fact that many of our cells are coated with patterns of sugar molecules that are like fingerprints identifying the cell as part of us, and not a cancer cell or an infecting organism. Some of these may be familiar to your readers, called HLA haplotypes. These molecular fingerprints are genetically inherited and are the “types” that define organ donor and blood type matches.

I had not considered this a significant issue and found it intriguing enough, when I met with them and they explained it to me, to change my way of thinking.

Why? Because if I say we dont need to eat any glucose because we can make all the glucose we need out of protein I could be making the same flawed argument our counterparts in the anti-cholesterol camp make, that is because we can manufacture cholesterol fat we don’t need to eat any. But I believe we do need to eat foods containing cholesterol because cholesterol also plays a role in the absorbtion and assimilation of fat soluble nutrients into chylomicrons, so it plays a role in facilitating digestion and nutrition in addition to its better known role as a main ingredient in our cell membranes. And though we CAN manufacture it, forcing our bodies to manufacture it may not be that good for us either. The same applies to sugar, even the non-essential sugars.

However, there is no data I am aware of that cites exactly how much sugar we need to coat our cells, and because too much glycation is a bad thing, as I describe in chapter 9 of Deep Nutrition, the number 100gm seems potentially too high.

So we need a new term to accompany safe-carbs: safe-glycation! Some glycation is essential to bodily function, but out of control glycation causes weight gain, metabolic imbalance, lipid abnormalities and more.

For my patients who want to achieve rapid weight loss, I continue recommending they cut their carbs down to 30 gm because of the need to reduce insulin resistance and harmful glycation. However, if they start feeling bad after a while (which I have yet to encounter), then I plan to advise them to eat up to 75-100 gm one to two days per week to see if that helps.

I don’t recommend all people need to avoid grains and legumes as a blanket rule, only those who have developed an intolerance to wheat or corn or any other starch. If they’re not sure if they’ve got an intolerance, the best thing to do is to try an elimination diet and see if the symptoms in question go away. Most antibody testing is woefully inaccurate. For more information on Dr. Shanahan’s philosophy on a gluten-free diet, read “What is celiac disease? A recipe for recovery beyond gluten free.”

AMY KUBAL, PALEO RD WHO BLOGS AT “FUEL AS RX” I am not ‘on-board’ with the 1lb of starchy carb for everyone recommendation that Jaminet makes. I feel that there is a place for starchy carbohydrate in a ‘low-carb’ diet for some people depending on goals and overall health status. It is definitely not a blanket recommendation for everyone.

Post workout is going to be the BEST time to incorporate the starchy carb, with portions depending on workout length, type and individual goals. Choices that work include sweet potatoes, yams, winter squash, beets, taro, rutabaga, white potatoes with skin removed, other roots and tubers and in the case of hard charging endurance athletes some white rice, tapioca and even corn tortillas from time to time can fit. For an extremely lean individual some starchy carb is going to be great. If weight loss and leaning out are the primary goals – then I recommend not getting all ‘starched up’.

As far as other vegetable based carbs not ‘counting’ because of the fiber… I’m not completely on board with that either. It is possible to get adequate carbohydrate via non-starchy vegetables. This is especially true in the non-active, overweight population.

The cancer argument – whoa! I can send you a boatload of articles on the benefits of a ketogenic diet for cancer. I’ve attached some of them and can send more if you would like. The diets that I have put together for cancer patients are low in carbohydrate (only from non-starchy vegetables), moderate to low in protein and rich in fat, primarily from MCT’s. Cancer cells live on sugar regardless of the source.

DR. ROBERT SU FROM “CARBOHYDRATES CAN KILL” For a long time, we had falsely believed that carbohydrate was our best energy source because it neither was greasy nor caused us fat, and that we could not live without it. Now, we know that carbohydrate can harm our health and develop diseases such as morbid obesity, diabetes mellitus, cardiovascular diseases, cancer, Alzheimer’s disease, and many more. Read more about Dr. Su’s philosophy on this in his column “Is There Essential Carbohydrate?”

MARK SISSON, AUTHOR OF PRIMAL BLUEPRINT AND “MARK’S DAILY APPLE” BLOG I see an unnecessary trend towards differentiation in the ancsetral/paleo/primal/lowcarb world. We are somehow trying to find all the ways we are different (which only confuses people) rather than identifying all the ways in which we are very alike and aligned, and then understanding the subtle differences that remain.

From my perspective, the Jaminet’s “Perfect Health” and my “Primal Blueprint” are quite close. Paul and Shou-Ching say not to eat cereal grains, legumes, high sugar/HFCS foods, and keep PUFAs low. I agree totally. Everyone is well-served by that.

They say you should take in 400-600 calories in the form of carbohydrate a day. I have said for years that 100-150 grams a day was the “Maintenance Zone” once you are at your ideal body composition. That equals 400-600 calories a day from carbs.

Jaminets allow temporary forays into low carb, “ketogenic” periods (at around 50 grams carbs a day). I agree that for rapid weight loss or on IF days that works well. Be clear that I am not a “carb hater” but prefer to look at carbs as an elective macronutrient. I am also a big fan of ketosis (I’m not sure Paul is as big a fan) and believe that being fat-adapted and keto-adapted greatly reduces the body’s need for glucose. I see no harm in staying in the 50-100 gram range for long periods ever, provided you’re otherwise eating primally and you are not a physical laborer or chronic-cardio participant.

The Jaminets say not to count vegetables in among your carb sources. Here’s a place we disagree. I argue that vegetable carb calories/grams are perfectly legitimate and a great source of micronutrients not otherwise present in modern high-fat or protein-based foods. I also believe that the only fiber we need is that found in adequate servings of fruits and veggies – and maybe the occasional tuber.

I agree that it’s fine to “supplement” carb intake with tubers (plaintains, sweet potatoes, etc) if needed or desired. He adds rice and white potatoes to that list. I have no problem with that, other than they are a bit further down the “acceptable” spectrum for me. I don’t pay much attention to GI, so that’s not an issue. So we’re still close. If his and my adherents are getting 100 grams of carbs a day from starches and 50 or so from veggies, we’re both in the ideal range (he’ll argue that we’re at the low end with 100 and not counting the veggies – I’ll argue that we’re at the high end, counting the veggies). No problem. A 50 gram swing here or there, day-to-day makes little difference over the long haul.

I am a fan of berries and not so much of other fruits, certainly not in copious amounts. He agrees.

I agree with Paul that dysbiosis is a problem with many people, but I believe the FOS in vegetables, along with an occasional (or regular) probiotic supplement, can offer a benefit. He might disagree with the FOS thing, but he still encourages copious vegetable intake, so it can’t be all that bad…

We both agree that fats should supply most of the calories.

Overall, I see how closely aligned we are. As we evolve in this way of thinking, the one truth that emerges is that our avoiding grains, HFCS, and seed oils will have a far greater impact on health than agonizing over dialing in all the rest of the minutiae. That’s where the n=1 starts to become valuable.

DR. LAUREN NOEL, NATUROPATHIC DOCTOR AND HOST OF “THE DR. LO SHOW” According to my knowledge, the only cells that require glucose for fuel are RBC’s because they lack mitochondria. Otherwise, all tissues can run on ketones. I’m not sure where his thought process comes from. I also see candida frequently in my practice, and putting patients on white rice and sweet potatoes is not a good idea. It would aggravate their condition. Perhaps in a completely healthy human being this may be a good diet, but most humans aren’t healthy. Everyone is uniquely different and therefore require a uniquely different diet.

DR. DANIEL CHONG, NATUROPATHIC PALEO PHYSICIAN This is an area that I have been interested in now for the last year or so. However, I have to admit, aside from some info I have read from Stephan Guyenet and the Kitava study, and Anthony Colpo, I haven’t researched it much (just learning a lot of different things in medicine these days). I am well aware of the Perfect Health Diet and think there are some very valid points. I just haven’t had the time to pick through it all.

My biggest concerns with low carb are its apparent effects on cortisol output and serotonin levels. I have yet to come across

1) “insufficient production of mucus in the digestive tract” leading to dysbiosis 2) vitamin deficiencies (he particularly mentions Vitamin C and glutathione on pages 253-254)

Nor am I aware of such advice for cancer patients either.

It all sounds quite interesting though. I just wish I could be a better source of info for you. If you want to talk about the dangers of EMFs and Earthing, though are two of my current areas of ongoing learning, as I think you heard my recent interview on that subject at Dr. Lo’s radio show.

I guess I’d just say that what first got me thinking about this whole topic was common sense. Common sense is why I got interested in the Paleo diet in the first place. There are studies out there to prove everything, so I don’t put all my eggs in the research basket. It does, however, make sense to eat what humans have eaten for the longest and what allowed us to grow big brains and separate from the rest of the animal world. However, it doesn’t make sense that the best diet within that umbrella would be low in starch, as that was the most common staple for the most people evolving during that time.

DR. GREG ELLIS, PROLIFIC LOW-CARB AUTHOR I did not buy the book and can only go from what I’m reading on the website. I can’t specifically find a definition for a “safe starch.” My thought is that much of this is just made up.

We have no need to eat any carbohydrates at all and glucose is one of the nastiest things we can eat. If you want to talk about toxins then glucose is at the top of the list. The body will produce all the glucose it needs via gluconeogenisis. If glycosylation is truly important there is enough glucose available to perform this function without eating glucose or carbs.

The distinction must be made between glycation of proteins and glycosylation. The first is not an enzymatic reaction and glucose just binds willy-nilly to the proteins of the body causing glycated proteins. There is no need for this process to occur and it is the root of most diseases including cancer.

All carbs digest to glucose and that means all of them are unsafe. There is no such thing as a safe carb and, yes, the quantitiy does matter because although glucose is dangereous we were built to handle a certain amount of many different toxins. Based on his calorie record, one would consume 100-125 grams of carb/day which is not terribly bad. His therapeutic ketogenic diet would supply 50 grams.

Therapeutic for what? Cancer. We know it will work for that but then he says wait a minute, we need glucose to make glycosylated proteins so this is a contradiction.

He also appears to be yet another advocate of a plant-based diet as are so many today and I’m sure has bought into the dangers of fat and cholesterol. Yet he recommends that 50-70% of calories come from fat. Pretty difficult to do on a plant-based diet. He says 2/3 plant foods.

My thought is that he just constructed this out of thin air, I don’t see any science here but just opinions and then the plan.

Why would a fungal condition benefit from more starch. Fungi must produce energy anaerobically as they have no mitochondria so can’t process it via oxygen. They thrive on sugar and so do cancer cells.

I just can’t see it and to me it’s just another form of zealotry which sucks everyone in since they can’t analyze anything he says.

A major factor that is being missed as is true about almost everybody talking about anything to do with diabetes is that diabetes, is not a disease of blood sugar (which is secondary), but a disease of abnormal hormone signaling, especially insulin and even more-so leptin, and this is primary. When one is relatively young or pre-diabetic, the secretion of insulin and leptin when one eats non fiber carbohydrates can compensate for the moderate intake of starch and other sugars, but it does so at the expense of greater and greater insulin and leptin resistance accumulated over months and years. One should not be fooled by focusing on so-called normal blood sugars. That is what the medical profession is and has been doing for the last half a century by giving patients unlimited amounts of insulin and multiple drugs that raise insulin while only looking at their blood sugar while ignoring the copious detriments of elevated insulin. The results are deadly as the ACCORD study showed, and that basic science has shown for at least two decades, that ‘medical science’ has also ignored. It is what goes on behind the glucose scene especially pertaining to metabolic hormones and future damage that must be paramount in ones thinking.

Also, there is really no totally safe level of blood sugar that will not cause non-enzymatic glycation or damage. The thresholds for diagnosing diabetes are arbitrary numbers. As such, I consider most everybody to have diabetes; just different degrees. Is the intake of 100 g daily of starch/sugar terrible? No, compared to the vast majority of diets being consumed. Can one hundred grams starch be tolerated? Yes, by most. Can it be called healthy? That depends on if one means healthy or healthier than what is unhealthy. My answer would be no. i.e. so-called ‘safe starches’, reduced metabolic stress, and manufacture of mucous;

Gluconeogenesis from amino acids/proteins is unhealthy, I agree. However, manufacturing glucose from glycerol is not a stressful or difficult process. One glycerol + one glycerol equals one glucose… The glycerol comes from the backbone of triglycerides when one is burning off the fatty acids. The key is to be able to burn the fatty acids i.e. burn fat. And the only way one can do that is by keeping insulin and glucose low.

One also cannot ignore the massive change (for the worse) in genetic expression pertaining to maintenance and repair, i.e. health, when one raises nutrient sensing hormones and pathways, especially insulin, leptin, mTOR, that almost 2 decades of very robust science has taught us.

When well adapted to burning fat, perhaps after 2 to 3 months, a person can derive virtually all their energy needs from fatty acids, ketones, and glucose derived from glycerol from fat. Also, it is virtually impossible not to ingest some sugar that would be found in nuts and vegetables even on a good low-carb RR diet.

Therefore, going out of your way to eat “safe starches” to raise blood sugar, is like going out of your way to glycate. Oh yeah, that is what safe starch proponents are also suggesting.. Eating extra glucose will not make mucus any more than taking calcium will make bone. There must be instructions to do so, and it must be an enzymatically directed. Enzymatically directed and beneficial glycation will happen regardless of our glucose intake, and damaging non-enzymatic glycation will happen far sooner and more often than we would care to realize and contribute to accelerated aging, disease, and our ultimate demise. It doesn’t need our help.

i.e. ‘safe starches’, cancer and glucose;

First, it must be noted that we all get/have some cancer cells most, if not all of the time…the below is pertinent to all people.

We must minimize excessive instructions for cells to reproduce/divide, therefore we must keep insulin/IGF, mTOR as low as possible. To do this, eliminate as much sugar/starch from the diet as possible. Therefore, one must keep glucose down. Ingest as little glucose/starch and other sugars as possible–not 100 gm, perhaps less than 50 gm. most days (and do not eat excess protein).

Paul Jaminet answers his question affirmatively by stating, “The brain is the biggest determinant of glucose needs. While other primates need only about 7% of energy as glucose or ketones, humans need about 20%. Compared to other primates, humans have a 12% smaller liver. This means we can’t manufacture as much glucose from protein as animals can. Humans also have a 40% smaller gut. This means we can’t manufacture many short-chain fatty acids, which supply ketones or glucogenic substrates, from plant fiber. So, while animals can meet their tiny glucose needs (5% of calories) in their big livers, humans may not be able to meet our big glucose needs (20-30% of calories) from our small livers. So any carbohydrate deficiency disease will strike humans only, not animals.”

I must disagree with Paul conceptually and factually. The brain needing 20% glucose is only under conditions of insufficient adaptation to burning ketones. Basic metabolic textbooks talk about adaptation to carbohydrate “starvation” when the brain starts deriving the vast majority of its energy needs from ketones derived from fat metabolism. After several weeks of adaptation the brain can derive at least 80% of its energy needs from ketones. After a longer period of time it can derive more. Regardless, the remainder of the brain’s energy needs can be met from gluconeogenesis using glycerol derived from the breakdown of triglycerides as substrate such that gluconeogenesis derived from amino acids is minimal to nonexistent, sparing lean mass. In fact, my patients who strictly adhered to my very low carbohydrate dietary recommendations generally increased lean mass without increasing exercise.

The size of the human liver has little to nothing to do with its metabolic abilities. Rather, it’s adaptation to available nutrients and even more importantly its control by, and indeed its sensitivity to metabolic hormones such as insulin and leptin are much more important to its function. Eating 100 g of glucose forming carbohydrates daily is enough to sufficiently raise insulin to shut down ketone production by the liver resulting in the necessity to use glucose as fuel by the brain. As such, what Jaminet is recommending is a self-fulfilling prophecy; requiring the consumption of glucose forming carbohydrates such as potatoes and rice increases blood glucose and insulin enough to greatly reduce ketone production, necessitating the use of glucose by the brain. This is not good. I have talked decades about the change in brain function when it converts from glucose to primarily ketone use; it becomes much healthier. Studies are now pouring in on the connection between glucose and chronic brain diseases. Jaminet rightly mentions the benefit of increasing ketone use in epilepsy. Epilepsy is an extreme of an over excitable brain. Is it possible that a brain primarily burning ketones as its primary fuel may function better all of the time? I believe strongly that the answer to this is yes.

Further counterpoints to the need for carbs;

I have never seen a list of essential nutrients that included a single carbohydrate. This means, that as far as current science knows, a human being does not have to take a single gram of carbohydrate their entire life to maintain health. This is because it is well known that although there is a certain need for carbohydrates and sugars, the body can make what it needs from other sources, either triglycerides or proteins. If the body is using fat as its primary fuel, then it needs (much) less glucose. The glucose that is necessary (more for anaerobic red blood cells than the brain) can either come from glycerol from the breakdown of triglycerides or from glucogenic amino acids that would be much less desirable. Deriving glucose from amino acids from protein requires either the consumption of excess protein–not good (I have written much about this previously) or the breakdown of lean mass–obviously not good, but no choice if one can’t eat i.e. while sleeping. So the real question becomes, not whether carbohydrates are needed, but what other sources will the body use as substrates to make the glucose that it needs while not necessitating oral consumption. By far, the best substrate for glucose manufacture is glycerol, but this is largely only available if one is oxidizing fatty acids from triglycerides, and this is not possible when one consumes glucose forming foods such as rice and potatoes thus raising insulin and leptin and shutting off fatty acid oxidation.

i.e. Leptin and a point of major importance that is a prime source of confusion, error, and division in the paleo and other health communities;

It appears to me that the paleo community has now been divided between a faction that backs Taubes who believes that insulin is supreme and the major cause of obesity, and a faction backed by Harris, Jaminet, Guyenet, and others who believe that insulin and glucose is less important and that leptin is more important in obesity and perhaps other diseases, and therefore eating so-called “safe starches” is OK if not even desirable. The major issue and source of confusion that I see, is that they are both half right and half wrong, but opposite halves. Taubes is right that sugars, starch, and elevated insulin are a major source of disease if not obesity that I heralded 2 decades ago, but not fully correct as to why. The Jaminet, Guyenet, Kruse, and Harris group is right that leptin likely supersedes insulin as far as importance in obesity, diabetes, and other chronic diseases, at least in humans. However, they are quite wrong in believing that it is therefore okay to consume “safe starches” that will largely digest into glucose. Though true that leptin, more than insulin, controls fat storage and perhaps even blood glucose levels, this does not mean that raising insulin levels via glucose is unimportant. It still plays a huge role in the control of genetic expression influencing the aging and chronic disease phenotype.

However they all, including Harris, Jaminet, Guyenet, Kruse, Taubes, and even those who have written books after me about leptin, seem to be missing a very critical and main functional point about leptin… Leptin levels and ultimately leptin resistance, and therefore chronic diseases of aging including obesity and diabetes, are determined more from spikes and elevations in glucose following meals than anything else including the amount of one’s stored fat. Though elevations in glucose raising insulin may not be the major cause of obesity and fat accumulation (though still very important), the fact that glucose spikes leptin still places sugars, including glucose from so-called “safe starches” and fructose, at the centerpiece of obesity and disease.

i.e. the longevity of the Okinawans and Kitavans:

First of all, population studies are the least scientifically robust form of health science. That being said, there are many speculations of why Okinawans have a high number of centenarians. Firstly, we must distinguish between increasing maximal lifespan that CR has been shown to do and I believe my diet can also do, and increasing average lifespan. Increasing average lifespan is nice but not near as powerful as extending youth and increasing maximum lifespan. For that there are no human counterpart and we have no footsteps to follow, only science as revealed in animal studies. That being said, the Okinawans eat considerably more fish than other groups and a higher percentage of carbohydrates as vegetables i.e. fiber as opposed to starches. Most of the fiber gets excreted, so Okinawans are likely relatively calorie restricted. Also, overindulging in food among Okinawans is very frowned upon.

What Nick Lane has said in his book “Oxygen” is the following, p 275; “based on a 25 year study, the book [The Okinawa Way written by a Japanese cardiologist] argues that the secret of the Okinawans… goes beyond genes, diet, and exercise to their relaxed lifestyle and low level of stress. The Okinawans have a word for it, “tege”, which means ‘half-done’: forget timetables, forget finishing today things that can be done tomorrow. I suspect they are probably right.”

In the most comprehensive study pertaining to the Okinawan diet and longevity entitled, “Caloric Restriction, the Traditional Okinawan Diet, and Healthy Aging” published in the Annals of the New York Academy of Sciences, the following was found; “Findings include low caloric intake and negative energy balance at younger ages, little weight gain with age, life-long low BMI…and survival patterns consistent with extended mean and maximum life span.” The study concluded; “This study [Caloric Restriction, the Traditional Okinawan Diet, and Healthy Aging] lends epidemiologic support for phenotypic benefits of CR in humans and is consistent with the well-known literature on animals with regard to CR phenotypes and healthy aging.”… I have not seen a breakdown of the calories eaten, but it’s known that they eat more fish and fibrous vegetables and lower calories. Simple logic could conclude that they eat fewer non-fiber carbohydrates, which, along with reduced stress, may account for their increased average lifespan.

Though my knowledge of the Kitavans is less, I believe much the same applies to them, and there are similar myths based on poor science and falsities that is being written about them that unfortunately is getting much unwarranted publicity.

DR. JOE LEONARDI, CHIROPRACTOR AND AUTHOR OF FAT THEN FIT NOW I have to admit that I am not very familiar with Dr. Jaminet’s work, I checked out his web site and with just a quick glance, he doesn’t seem extremely different from my thinking, with the exception of the starches. I am interested to learn more about his theories, however for now, I am forming my response based upon the contents of your email.

On the topic of “safe starches,” one of the aspects I have mentioned in interviews and speaking engagements is the fact that many of what Dr. Paul Jaminet refers to as “safe starches” are not what they once were. With the advent of global agribusiness and genetic engineering, many of these starches contain an over abundance of polysaccharides per item. A white potato, when I was younger was on average about 1/2 the size of my fist, today it is about 1/2 the size of my upper arm. This increase in size is all saccharides and if one were to consume potatoes he or she would have to be aware of this, however, Dr Jaminet’s recommendations do have a restriction on the total amount of consumed carbohydrate, and since he his recommending a prescribed amount, the size of an individual potato is irrelevant in his methodology.

I have read from other sources about some of his rational for consuming carbohydrates. Regardless if what he says is 100% accurate, I am of the belief that our bodies do in fact require some carbohydrates. Human physiology functions on ingestion of all the macro-nutrients. The issue for optimum health and weight management is the source and proportion. Those of us who advocate a more whole food, primal/paleo, lower carbohydrate diet are concerned with avoiding overly processed foods including breads, pastas, cereals, etc. Moreover, we don’t accept the vilification of dietary fats from as close to natural sources as possible. From what you have sent me, it appears that his “safe starches” are all foods that can be found in a natural state.

Paul Jaminet’s recommendations do not really fall to far from the mark, from what I recall, of Dr. Atkins’s original recommendations. Dr. Atkins did not recommend long term carbohydrate restriction in the 20 gram range. If my memory serves me correctly, he stated as we moved into maintenance, we should add carbohydrates back into our diet, while monitoring our weight, until we reached an appropriate balance.

In my book I don’t give breakdowns in grams, calories or percentages, I give guidelines, which if followed, keep an overall balance. When I am maintaining my weight, I keep my carbohydrate consumption in the 60-80 gram range. For me personally, anything above that and I start to add some weight and my energy level drops. Additionally in my book, in the second and third dietary stages, I recommend eating carbohydrates from fresh fruit sources.

Since all polysaccharides are broken down into component parts of glucose, fructose and galactose, depending on their source, I don’t really have an issue with his “safe starch” list. I tend to go more for fresh, small farm, locally grown fruits, simply because many of the “safe starches” have been so modified I am unsure of the quality of their nutrient content. This may be a risk with the fruits I consume, of course, but I am personally more comfortable with fruit as a source of carbohydrate.

DR. BG FROM THE “ANIMAL PHARM” BLOG My ideas on safe starches revolves around repairing adrenal function. So many of us are damaged adrenally. Carbs improve the situation! It can be anything (even sugar)! According to Wilson’s book Adrenal Fatigue he advises ~2 carbs per meal and 1/2 -1 carb per snack–105 grams or more per day in other words. Before I cycled 40 grams on low carb days up to 80 grams on work out days. I’ve been doing upwards of 100-120 grams on the ‘cortisol’ days because Schwarzbein advises in order to fix the adrenals, the serum insulin needs to be higher than the cortisol. I don’t recall her being too specific with the labs but I feel ‘better’ on higher carbs for the adrenals.

According to a lot of statistics, a lot of people have incompetent adrenals. On Paleohacks there are countless stories of people on VLC paleo who feel dizzy or lightheaded. H-E-L-L-O this is cardinal signs and symptoms of adrenal fatigue. Many of these folks are also doing HIIT and hard core CROSSFIT!

My thoughts involve getting diagnosed for adrenal incompetence then treat accordingly with carbs (any carbs). When the adrenals perk up, then the thyroid will perk up as well. Men with low Testosterone will start experiencing improved libido, higher free T and s*xxxiness again. Women — infertility, PCOS and menstrual dysfunction also improve! Adrenals are the spark plugs for our energy flow. Unfortunately they require adequate cortisol. Again cortisol gets pounded by low blood glucoses, ketosis, fasting and other forms of glycolytic ‘stressors’ like endurance or high intensity exericse or heavy lifting.

ZOE HARCOMBE, BRITISH OBESITY RESEARCHER AND AUTHOR When asked any question about what we should eat, I always go back to first principles – we eat because we need fuel (calories), macro nutrients and micro nutrients. We can safely assume, in the ‘developed’ world, that we no longer have difficulty getting enough fuel – the debate is more – in which form should that fuel come. The macro nutrients that we need are fat (not least for the essential fats) and protein (essential and other amino acids). I do not believe that we need carbohydrates – but that’s what this query is about, so we’ll come back to that. We also need 13 vitamins and c. 16 minerals.

All fuel, fats, proteins, vitamins and minerals can be supplied by animal foods and this must be the case or our ancestors would not have survived the 30,000 year ice age, which ended but 10,000 years ago. Liver (and animal glands) can supply vitamin C and our need for vitamin C is substantially reduced if we don’t eat carbohydrates (vitamin C uses the same receptors as glucose to enter the cell membrane, so, if we have eaten lots of carbs, less vitamin C can be absorbed because the receptors are in use and therefore we need more.) Hence we can obtain all the nutrition that we need from food without eating carbs.

My preferred way to get vitamin C is from vegetables, not raw liver (vit C is largely destroyed in cooking). Hence I’m pleased to see that vegetables are ‘free’ in Paul Jaminet’s plan, as I think most people should be eating non starchy vegetables and salads freely. Only the most carbohydrate sensitive people may need to count carbs to the level of those in vegetables and salads.

I haven’t got Paul’s book, so I can only go on the query as emailed from Jimmy. On this basis I understand that ‘safe’ starches are considered to be potatoes, sweet potatoes (as the name suggests – sweeter than normal potatoes), rice, yams, plantains etc. As raw products, these range from 18g of carb per 100g weight (normal potato) to 80g of carb per 100g for white rice. Cooked, rice comes down to about 28g of carb, as water is absorbed. (Sunflower seeds have 20g of carb per 100g and almonds have 22g – these are far more nutritious foods if you want to go to that level of carb and get a better ‘bang for the buck’ – especially sunflower seeds for vitamin E. Dairy too – at c 5% carb, as a rule of thumb and packed with calcium and vitamins A and D – would be far higher on my list than any starches).

It may be a minor point, but we also eat for taste and these products are simply tasteless in my view. Rice is nothing without an awesome curry; potatoes are nothing without melted cheese and butter – so have the curry, cheese and butter and ditch the bland starches! I gagged when I first tried plantain, or was it a yam – same difference. No wonder these were not under the “pleasure foods” label! Do we need carbs in the diet at all? No. We simply cannot have evolved to need them or we wouldn’t be here.

Do we need carbs for vitamin C? No. Vitamin C can be amply supplied in Paul’s plan by vegetables – raw yellow pepper being one of the best sources; raw broccoli similarly. They can be supplied without carbs, period.

Do we need carbs to counter dysbiosis? I can only see how carbs would make digestive flora more imbalanced – not less. We know that Candida is one of the major gut inhabitants prone to overgrowth. Bacterial dysbiosis flourishes in similar circumstances of imbalance and Candida loves to feed on sugars. The glucose into which starchy foods are broken down feeds Candida beautifully. When I wrote “Why do you overeat? When all you want is to be slim” (2004) and explored Candida at length, as a driver of food cravings, I researched the original experts in the field of Candida: Chaitow (Candida Albicans: Could yeast be your problem?); Trowbridge & Walker (The Yeast Syndrome) and Crook (The Yeast Connection). Chaitow, Trowbridge & Walker all banned potatoes and Crook’s advice was to eat them with caution. Chaitow allowed brown rice; Trowbridge & Walker allowed none and Crook again advised eating rice with caution. Hence I really cannot see how eating carbs would help with gut balance.

The other concerns I have about starches, which do not make me consider them safe, are:

1) There are 171 million diabetes sufferers worldwide and the World Health Organisation XE “World Health Organisation” estimate is that this will rise to 366 million by 2030. 95% of these are type 2. The macronutrient that can cause diabetes is carbohydrate. Why do we want to encourage consumption of starches in this circumstance?

2) The normal blood glucose range is 0.8 – 1.1 grams of glucose per litre of blood. An average human has 5 litres of blood, so that’s 4 – 5.5 grams of glucose needed in the blood stream at any time. With glucose approximating to 4 calories per gram, this equates to about 16 – 22 calories of glucose. That’s a teaspoon of sugar. This page recommends “Daily carbohydrate intake should be 400-600 calories, primarily from starches”. That’s 25-38 times the amount needed to get the body to the bottom of the normal range – and we would not be starting from 0. This is frightening.

3) I specialize in obesity and weight loss – that’s my passion. As Gary Taubes beautifully explained – gaining weight is defined by creation of triglyceride (fat structure) and weight loss is defined by breaking down triglyceride. The former happens when carbs provide glucose to provide the glycerol ‘backbone’ to join three fats together. The latter happens when there is no glucose available and the body can break down the triglyceride to get glycerol/glucose and fat for fuel. Again – why would we want to encourage consumption of starch (glucose) in the midst of an obesity epidemic?

I like a great deal about Paul’s plan: real food, not processed; no sugar or grains; no vegetable oils; proper fats like lard and butter; plenty of meat, fish and eggs; fruits only in moderation; chocolate (I assume very dark) rightly recognized as a pleasure – and a fantastic source of many difficult-to-get minerals like copper, iron, magnesium and manganese etc. There are only two things I don’t like – sweeteners and starches. Ditch those and this would be great advice.

DR. STEPHEN PHINNEY, LONG-TIME LOW-CARB DIET RESEARCHER AND AUTHOROn the topic of dietary carbohydrates of any kind and blood glucose regulation: Clearly some carbohydrate foods raise blood glucose more than others, which is the basis for both the ‘glycemic index’ and presumably the ‘safe starches’ concepts. In part, how fast your body absorbs the carbohydrates you eat influences how these energy sources are processed.

The other half of this picture is how promptly your body can ‘tuck away’ the absorbed carbohydrate, which passes through the blood stream mostly as glucose (which means you need both adequate insulin in the blood and insulin sensitive cells to clear it).

Insulin resistance (the hallmark of both metabolic syndrome and type-2 diabetes) occurs to a varying degree in many of us. Thus the more insulin resistant we are, the less tolerant we are of dietary carbohydrate from the different dietary sources (i.e., one persons ‘safe starch’ may far exceed the carbohydrate tolerance of someone else who is more insulin resistant). Many people with type-2 diabetes go into complete remission when they eat less than 50 grams per day of total carbohydrate, but remain diabetic if they eat 100-150 grams (400-600 Calories) of carbohydrate (independent of what grain or tuber it comes from).

There is no absolute human requirement for dietary carbohydrate. In our many published studies of human research subjects given well-formulated very low carbohydrate diets (e.g., 5-50 grams of total carbohydrate per day), we never observed low blood sugar levels. In fact, in my 1983 study of bicycle racers eating an Inuit diet, even when we exercised them to exhaustion, their blood glucose values remained normal. Simply put, if the body maintains a normal blood glucose level with little or no carbohydrate sources in the diet, how can one argue that they are required?

If the level of glucose during a well-formulated very low carbohydrate diet is maintained in the normal range, how can one credibly postulate inadequate glucose availability for glycosylation?

On the topic of vitamins In both his Arctic experience and his Bellevue experiment, Stefansson dealt with the issue of vitamin deficiencies on the aboriginal Inuit diet. If anything, the inclusion of white rice in one’s diet (which has been stripped of its vitamins including thiamin) raises more concerns than answers. There are no reports of vitamin inadequacy in people eating well-formulated ketogenic diets (including the copious vegetables and moderate berry fruit recommended in our two recent books).

On the topic of dysbiosis Various parts of the body produce mucous under inflammatory challenge (e.g., the nose when challenged by a virus or allergen). Multiple human studies (some by us) have demonstrated that dietary carbohydrates increase the body’s level of inflammation, so it is not surprising that adding more carbohydrate to the diet increases intestinal mucous production. But what puzzles me is why one would think this is a good thing? As we have repeatedly demonstrated, when fluids and minerals are properly managed, digestion and colon functions are well maintain (if not markedly improved) during a well-formulated ketogenic diet.

Now that you’ve heard from the low-carb and Paleo experts, let’s hear from YOU and what you think about this whole controversy surrounding the so-called “safe starches” promoted by Paul Jaminet in his book The Perfect Health Diet. This is an important discussion and I look forward to the open exchange of ideas on this. Let the conversation begin!

Thank you SO MUCH for this. I’m coming up on the first anniversary of my going from vegan (for 18 years!) to Paleo last October. I saw the “safe starches” post and it really confused me. You’ve performed a real public service here!

Anonymous

Hi Jimmy,

Thanks for organizing this colloquium. I’ll be responding on my blog. I’ve already put up a discussion of Kurt Harris’s post, with which I almost entirely agree (http://perfecthealthdiet.com/?p=4802), and I’ll respond to the others over the next few weeks.

Best, Paul

Anonymous

ENJOY Paul!

Wolfstriked Optimalo

Jimmy,that is an amazing collection of info you have gathered here.I read it slowly and that alone says alot.My experience seems to counter the safe starch suggestions also.I did the butter,eggs,meat and rice meals and my blood sugar was all over the place.Some days I felt excellent and others I felt like I was going into diabetic comas.The days I felt great I had excessive energy and most likely my blood sugar was peaking but not dropping while the days I felt bad my blood sugar was severely dipping.And your statement of being weary of what you read on internet is a very important point.I have for many yrs stumbled from diet to diet seeking the optimal diet to eat sadly getting unhealthy in the process.

I am in same boat with the people that say that it all boils down to your body.for example me….I know I have a damaged liver from drinking and I believe that this causes the liver to not be able to regulate BS adequately.This would make one think I should go VLC but I find then that I am in low carb hell constantly.So I also believe that my damaged liver has a hard time with gluconeogenesis and hence has hard time making the small amount of glucose the body needs from protein.I find that the OD is my fix.The 50gms of carbs is low enough to keep me in ketosis while fixing my issue where I seem to feel worse and worse when I go VLC.But there are people that thrive on carbs and so the PHD would probably be excellent for them.It steers them away from soda and that right there is huge!!

About cancers…some say sugar while others say mucous deficiency while others say environmental toxins etc etc.Could it be PH.Most cancer patients have very low body PH afterall.Could it be the acidity of large intake of soda,the acidifying effect from smog and cigarettes and other environmental toxins and even a lack of hardwater consumption to counter acidity.NYC tap water has a PH of 5.0 and ever since I started drinking my filtered water with baking soda to neutralize it my energy has gone thru the roof….my candida is still dying off etc etc.I post this video of a man that cured his “bone cancer” with baking soda………..

Drew Stearns

Thanks for the awesome article, Jimmy!

I was surprised to see that with the exception of Robb Wolf, nobody mentioned the importance of glycogen.

Any scenario where there is more carbohydrate than can fit into your glycogen stores is where trouble occurs.

Figuring out just how much room you have left in your glycogen stores – and thus, how much carbohydrate you can safely consume- is the tricky part.

http://profiles.google.com/hemoglobina1c Kurt Harris

1) It is hard to actually exceed your glycogen limits

2) If you did, the carbs are still preferentially burned first, and any excess fat from the diet is stored first.

Vanessa Romero

Wow! This was a great round-up of all the experts! Thank you!!!!

http://weightmaven.org Beth@WeightMaven

Thanks for this post! I’m looking forward to seeing what Paul does with all of these comments. Should be great fodder on his blog for a while.

Two comments I wanted to make. One, I’m not sure it’s fair to compare what someone’s BG does eating a safe starch if they have been doing VLC for a while. The lack of carbs in the diet means that some required enzymes are down-regulated; this is why you find all the recommendations to eat 150g of carbs for three days before an OGTT … if you don’t adapt to carbs before the test, your BG will skyrocket on the glucose (kinda the opposite of the low-carb flu).

Two, re your RD who has “never heard of a fiber being called a fat” … I suppose it was the lack of context in the snippet you quoted, but I believe Paul is referring to the process where fermentation of fibers in the gut results in short chain fatty acid production. So it’s fiber, but it’s also technically a fat source.

http://www.facebook.com/people/Lance-Strish/666889531 Lance Strish

I don’t do too well with white rice (similar gut irritation and stool consistency as w/ bread grains) if eaten too much. Sweet potatoes are different for me. I may try white potatoes next (but worry about glycoalkaloids).

http://www.lowcarbconversations.com/344/22-barbara-rose-dean-dwyer-paleo-guy-weston-price-gal-discuss-body-image-more/#comment-306963040 Maybe try 150g for 3 days to see how a blood sugar test goes. Anecdotally, I have noticed decreased bellyfat from 150g worth of potato after 1.5 weeks. One thing I think may help to get 150g carbs down is eat the potato right before going to bed (and you will have wild dreams each time). You will also not have the blood sugar swings vs eating them in the morning. I also recommend a quarter of raw red-onion right before bed and you will feel rejuvenated in the morning (muscles “ready to take on the day”… I believe it is the quercetin recycling the vitamin c that may explain this effect).-Just like the saying you have to ‘eat fat to burn fat’ you have to ‘eat carbs to be insulin sensitive’ (see link above). I’m trying to keep insulin sensitive because you can never get rid of glucose and what if cortisol goes off (from everyday stressors, bad sleep) And I know Robb wolf has tempered his approach to carbs (ep 99, 100 paleo solution and http://is.gd/u1eLjV and some recent twitter updates).And Robb Wolf’s book excerpt on cortisol and blood sugar:”Cortisol raises blood sugar levels, which can cause fat gain. Although many people don’t know this, cortisol release from stress and a lack of sleepfactors prominently in body fat gain, leading to that pesky spare tire around the midsection. Cortisol shouldn’t be feared, because it is a crucial antiinflamatory— we just don’t want too much of it. ____________________________ Geek-Speak Cortisol is often referred to as a “stress hormone,” given that it is released in response to stress and anxiety. Cortisol increases blood pressure and acts as an anti-inflammatory by lowering the activity of the immune system. It will trigger the breakdown of muscle mass by converting protein (amino acids) into glucose via gluconeogenesis. Cortisol decreases insulin sensitivity, lowers the rate of bone formation, and causes a loss of collagen in the skin and other connective tissues. The following increase cortisol levels: intense or prolonged physical activity, caffeine, sleep deprivation, stress, subcutaneous fat tissue, and certain contraceptives.” Cortisol is up there with insulin as one of the master hormones. I believe Dr Perricone once referred to it as a ‘death hormone’ and Transcend Dr Grossman said insulin and cortisol are the hormones of aging.

– And Don said this recently on mixing fat and carbohydrate to keep in mind:

“High fat intake definitely increases insulin resistance and thus promotes higher blood sugar levels when you eat carbohydrate. Hence, it seems that the more carbohydrate you eat, the less fat you can tolerate, and vice versa.” http://donmatesz.blogspot.com/2011/09/iron-oxidation-inflammation-and-aging.html?showComment=1317867363128#c7766310590619649978

and to eat with protein “What do you mean when you say you get hypoglycemic?

And I have also noticed a bit more spring in my step when walking with these potatoes so maybe try it out with volleyball.

Allison

Very timely blog topic! I am anxious to hear from Nora Gedgaudas. She has a higher fat recommendation with being careful about blood glucose levels.

Rafaelgray

Best blog post ever! Hope to see the rebuttals post in the future. Thanks

Barb

Really great piece. Loved all the people who weighed in on the subject. Thank you so much for taking the time to collect these responses.

sixtyfive

This is very helpful. Most if not all of us who follow you are interested in weight loss. We are not molecular biologists, and the “science” usually flies right over our heads. We find ourselves agreeing with people who may have very opposite viewpoints just because they APPEAR to know whereof they speak. Based on what I’m reading here I’m going to stay away from the “safe starches” for a while.

Gforce

I have included safe starches for the last 8 months since reading PHD. My health and body fat and never been better, I was about somewhere between 14 to 20% body fat while eating low carb with lots and lots of fat to about 10 to 12% since I have added lots and lots of Japenease Yams and some sweet potatoes, a little more fruit (2 pieces a day). I have reduced the amount of fat. Only eat grass fed butter and coconut oil with grass fed beef and pastured eggs. Along with my yams or sweet potatoes, rice a couple of times. My weight training has exploded, my muscles have really filled out with the glycogen added to my diet. My abs are ripped and my interval training has been much more fun. The Paleo movement has moved to this diet, Matt Lalonde, Robb Wolf, Kurt Harris, Stephen Gunyet, Chris Kessler even Don Maetoz have began to add safe starches and recommend them. (please forgive my spelling, but you know who I am talking about) I would also like to add, that I think my cognitive function has improved. I will never go back to not eating potatoes VLC, I still will not eat wheat, other grains (very rare, maybe white rice), nuts, legumes though.

http://pulse.yahoo.com/_6ZPXB5DBFDYKX36DEYLTOH6XM4 Space Vegetable

Seems like your activity levels are high enough to warrant additional starches. That’s not the case with those of us not “filling out” our muscles or doing heavy weight training.

Anonymous

What a terrific compilation. Though very strict LC has worked well for me for weight loss in the past, I too have been having lots of questions about whether/what I would need to add to my diet starch-wise now that I’ve started Crossfit.

GalinaL

Why not to continue our n=1 experiments and check it out? Probably it is a good time to go back to Atkins plan or Dr.Eades “Protein Power” book and find out the individual level of safe carbohydrates?

Anonymous

That’s what I’ll be testing in November, Galina.

GalinaL

I tested bringing back into diet more carbs myself because I now in a maintenance stage of a weight loss. It was fine at the beginning, but very slowly weight and waist started to increase. I took nearly 4 years to loose and I am not prepared to risk my result yet. IF allows me more flexibility, though. During the testing I noticed that now I can eat carbs without loosing control of my appetite, so some healing took place.

Anonymous

Awesome Galina! Good for you to experiment and find out for yourself. I’ll be doing that soon and will ask Paul Jaminet to guide me on how to prepare for this n=1 experiment.

Haggus Lividus

You’re timing couldn’t be better Mr. Moore!

Yesterday I pulled one of my n=1 tests to see how I would handle rice. I left out the animal sacrifice, but everything else stayed the same. Some background: I’m IGT have an a1c that bounces around 4.8 and 5%. I normally see a .2 to .3mmol/L rise in my BG levels with the tuna, eggs, or beef I normally have for breakfast.

So here are the deets:

This is what I ate.

1 Sugar Twin (Canadian version)

1 Rice 051011 recipe.

Butter Trace

Brown Rice 28.5714g

Water 100g

Kcalories 102 kcal

Carbohydrate 20.32g

Fiber 0.67g

Protein 1.91g

Fat 0.99g

1g Instant Coffee

1g Cocoa, dry powder, unsweetened

2g Coconut Oil

4drops Liquid Sucralose

900g Water

Calories 125 Carbs 21.7 Fiber 1 Protein 2.2 Fat 3.1

This is what my blood sugars did:

050911 1036 4.8 Fast BG level

050911 1100 5.9 15m

050911 1116 6.9 31m

050911 1131 7.7 46m

050911 1145 6.9 1h

050911 1200 5.8 1h15m

050911 1215 5.4 1h30m

050911 1230 5.2 1h45m

050911 1245 5.4 2h

050911 1300 5.2 2h15m

For those south of the 49th, just multiply the number by 18 to get mg/dL figures.

Today, I tested out sweet potatoes and have yet to enter all the numbers, but I peeked at 6mmol/L but only slowly drifted down. I ended up with a BG of 5.5 after 2h and 15m.

Finally, it appears that the term ‘safe starch’ doesn’t seem to mean safe BG levels for me. Because of this, I’ve dropped a dozen or so blogs that espouse this Paleo Carbfest.

http://www.carbohydratescankill.com Robert K. Su, MD

Excellent. Your serial BG tests underscore my assertion that it is a terrible advice that most, if not all, of us should eat 100 grams or more daily carbohydrates, especially those with starch or high glycemic indices, for good health. I just wish those who made or will make such an advice should do serial BG tests in related to the foods, which they suggest for others to follow. We must realize that there are diseases, which can be either acute and chronic, depending on the strength or level of the individual’s BG and its resulted inflammation.

http://profiles.google.com/matthew.brody Matt Brody

But you assume BG is the end-all-discussion measurement of health, regardless of the individual’s level of metabolically derangement. The theory here is that glucose-containing foods are not the cause of metabolic derangement; concentrated fructose and other toxins cause the metabolic derangement. Once deranged it is indeed more important to maintain BG within range, but if fasting BG is appropriate, your body can do its job, use insulin to process the glucose that is obtained from food, and all is well.

http://www.carbohydratescankill.com Robert K. Su, MD

Not exactly. the ramifications of hyperglycemia are of major concerns. However, hyperglycemia is the root of most, if not all, of the health problems. Please visit my website and look for a three-part article, ” carbohydrates Can Kill: Hyperglycemia is problematic but preventable by restricting carbohydrates”, and another one, “A Silent Killer: Hyperglycemia At Anytime Bt Fasting and 2-hour Postprandial.”

http://malpaz.wordpress.com/ Mallory

UMM…. if you would read the other comments. going from VLC to adding starches, this is EXPECTED to happen. your insulin resistant, common sense buddy….

if you kept at this for a week or so i bet your BS levels would normalize…

http://pulse.yahoo.com/_6ZPXB5DBFDYKX36DEYLTOH6XM4 Space Vegetable

Why is it expected? Does ketosis have an impact upon how the body processes carbs?

GalinaL

Yes it does.After adaptation to ketosis, you body saves glucose for the sells that take nothing else and your peripheral muscular sells became physiologically, not pathologically, insulin resistant. It is the result of ketono-adaptation and it will be reverse if you change your diet, but it will take some days.

NG

Next time add a substantial amount of fat to your carbs and see what happens to your BG.

Anonymous

Fat and carbs combined–that’s not a healthy combination.

Haggus Lividus

I did days later. Instead of a 2.9mmol/L jump, I had a 1.0mmol/L bump. That’s still nearly double (.6mmol/L bump) that I normally sport during any regular meal where non-starchy veggies are involved. Either way, the sweet potato was tasty, but if I’m going to cheat, I find a slice of a turtle cheesecake to be even tastier. In the meantime, I’ve finished my carbfest tests for now as frankly, I feel better when closer to ketogenic levels. But that’s me.

Jay Jay

I’ve read your blog for at least 2 years but have never commented before. But I feel I must now.

This is the most disturbing post I have read here. Few of these experts have even read the Perfect Health book, yet they feel free to blast away.

Just to hit a few of the recurrent themes in the expert comments, the book clearly states that “safe carbs” aren’t for everybody. Only for those few folks who know they can safely handle them. And there is plenty of discussion in the book about which types of folks should most likely stick to a ketogenic VLC diet.

And there is no implication in the book that the “safe carbs” are safe for everybody. They call them safe because they lack the potential poisons which are present in grains and some fruits. This again is spelled out very clearly in the book.

And the process of converting plant based fiber into fats through bacterial digestion is very clearly explained in the Perfect Heath book. Again, if more of your commentors would have read the book before commenting, they would have understood this before flying off the deep end.

In fact, I consider many of the comments you have provided here to be very enlightening. In the future, I will consider advice from many of these folks with increased skepticism.

And I am especially shocked that you included a comment from a Dr who considered his discussion with you to be off the record. I assume you meant no harm with the inclusion of that quote, but it does force me to question your judgment.

Anonymous

All of the people quoted gave me permission to quote them for this column.

Jay Jay

OK, thanks for clarifying that.

I see you have since removed the line that made me think otherwise. And added a whole lot more!

Thanks again. I really don’t want to sound too harsh here, because I do truly appreciate what you personally do. I don’t want to shoot the messenger. I’m just surprised at some of the responses you got to your question.

Anonymous

It was eye-opening.

http://profiles.google.com/hemoglobina1c Kurt Harris

The question is why do we care what he thinks if he is off the record? Why include “him”?

Mario Fringes

“In fact, I consider many of the comments you have provided here to be very enlightening. In the future, I will consider advice from many of these folks with increased skepticism.”

Exactly!

http://twitter.com/jimsutton1 Jim Sutton

Having read the PHD book, I had all of the same questions/observations that you had JJ.

Well said.

Elenor Snow

“the book clearly states that “safe carbs” aren’t for everybody. Only for those few folks who know they can safely handle them …. there is no implication in the book that the “safe carbs” are safe for everybody.”

The **title** of the book (which I have not read either) is NOT “The Perfect Diet for the very few people who can handle these sorts of carbs” — its, essentially, “hey everyone, you CAN eat potatoes and rice!” As one of the “metabolically deranged” (pre-diabetic; overweight; insulin resistant and, I’d guess, leptin resistant too; with debilitated thyroid and adrenals) — I’m one of probably many who said: “oh, hey — people ‘in the know’ are saying rice is okay… so I can have rice.” And my A1C went from 5.5 to 6.2.

I see a huge problem right now in the LC and paleo/primal worlds — there are two entirely different audiences: all the extreme Cross-fitting 20-somethings with pretty good health and undamaged metabolisms; and those of us with deranged metabolisms and/or lots of age on us (and lots of AGEs). Oh, and maybe it’s three audiences — if you add those with cancers, whose ‘version’ of the WOE might be different still.

I think until people begin identifying their intended audiences, we’re going to have a lot of snarling and barking, because what’s sauce for one kind of goose is NOT sauce for another! (Low-carb, of course.)

http://weightmaven.org Beth@WeightMaven

But the audiences are not that black & white. I’m not 20-something, nor am I into Cross-fit, but I am finding the PHD “safe starches” to work fine in my weight loss efforts despite my metabolic issues. After all, 100g of carbs — starches or not — is still a lower carb diet.

Melissa

Yikes, some ethnographic issues abounding here. Chris Masterjohn has delved into the literature on the Masaai and they did not exactly eat a VLC diet and in fact traded with their neighbors for starch. As for Tom’s Irish ancestors, there is plenty of evidence they ate berries and various roots. I model my diet on my ancient Celtic ancestors and I eat roots and berries when they are in season and meat/fish in every season.

Either way, starch is starch and the data doesn’t show any difference in glycemic index between Cordain’s sweet potatoes and Paul’s white potatoes. And anyone going from VLC to eating them is going to have blood sugar issues because your body isn’t used to dealing with that anymore. Eventually they will have less of an effect. I’m sure if I tested them in the summer and again in the winter, I’d have less of a glycemic effect in the summer.

http://profiles.google.com/hemoglobina1c Kurt Harris

Hey Melissa

The wife and I were watching nat geo channel the other day and we saw a supposedly 100% carnivorous polar bear in the arctic eating ……copious amounts of kelp!

Melissa is right about transitioning from VLC. You will take TIME to get back normal glucoregulatory control with re-introduction of starch because VLC makes you insulin resistant!

oliver griswold

Bears are omnivores so I’m not sure kelp is that out of the ordinary for a polar bear. Yes, their climate dictates much more of a carnivorous diet as with the Inuit but they still are omnivores right?

http://profiles.google.com/hemoglobina1c Kurt Harris

Polar bears can interbreed with obviously omnivorous brown bears, but are considered a separate species. One often reads that polar bears are as carnivorous as big cats, and it would stand to reason given the lack of vegetable matter on arctic floe ice…

The point was indeed that even a highly carnivorous polar bear eats carbohydrate plant material.

Melissa

Yes, but neither the polar bear nor the Inuit are getting much starch. I don’t think you need any if you are doing a truly Inuit-style low-carb diet that includes organ meats, seaweed, occasional berries, wild greens, and plenty of fat. But then again I don’t think there is any evidence that starch is bad for the average lean healthy person and that keto is some kind of optimum. Is it so radical to tell people to do what works for them? Seems so.

http://profiles.google.com/hemoglobina1c Kurt Harris

Good grief! It was just meant to be an ironic observation…

Melissa

I know, just musing

http://www.carbohydratescankill.com Robert K. Su, MD

Thank you very much, Jimmy for including me in your great article. We all can talk a lot of things about how adding more carbohydrates can help us improve our feeling without adding our poundage. In my practice, I have seen many patients who have never been overweight or obese but a “perfect” diabetic. Why? They eat less foods but most of their foods are carbohydrates. So, they stay slim or even underweight. However, their blood glycemic level after each meal triggers inflammation all over their body. The key issue is not a matter of safe starch, but is to maintain a steady blood glycemic level within a normal range, preferable between 70 and 100 mg%, or at least not over 120 mg%. I applaud you for planning to conduct a self-experiment (n = 1) with the “safe starch.” Please bear with me and do a serial blood glucose tests started at fasting and an interval of 15 minutes for two hours. I know you would not mind to share your results with us. I know the results will be different between all of us depending on the state of our individual beta cells. I am not kidding!

http://profiles.google.com/hemoglobina1c Kurt Harris

I hope you would also encourage him to eat at least 150 g a day of carbs for a few days before testing so the result is not meaningless…

Abe

Just one note about the first reviewer’s comment, from Colette at Atkins.com: Glycation and glycosylation are not the same thing, are they? One (glycosylation) is enzyme-controlled, and is an important biological process; the other (glycation) is a haphazard and uncontrolled bonding of sugar and protein molecules, which has a deleterious effect on the body. Knowing this, should we really take your word in this matter?

http://www.archevore.com Kurt Harris MD

@PrimalKitchen:disqus Dr. Kruse’While i like both of these guys, neither one has any clinical experience treating cancer patients. They read literature. When kurt was a practicing doc he spent time in a dark room with films not patients. I showed our oncologist these comments and they both shook their head.”I suppose referring to my by my Christian name when I have never met you supports the impression you know a single thing about my clinical practice or career.You don’t. I have had varied and intimate contact with patients doing interventional radiology, including neurointerventional for over 25 years. For 6 years I performed a person consultation with all of my patients at my own private imaging center – that would be about 12,000 in-person patient encounters. This is where I started treating patients with my diet, through this local contact. And I continue to do it locally and in internet consultation, even if you don’t know it because I am not as loud about it as some…I am not clear on what being an oncologist has to do with anything, but you are no more of an oncologist than I am. You are a dentist and neurosurgeon. Try sticking to your crackpot theorizing rather than knocking a radiologist and physicist for the “madness” of thinking you might not die if you eat a potato….

http://profiles.google.com/hemoglobina1c Kurt Harris

The autofill must have put in primal kitchen I have no affiliation with primal kitchen

The post is directed at Dr. Kruse and the formatting was not preserved…

http://profiles.google.com/hemoglobina1c Kurt Harris

@Jimmy:disqus

Hi Jimmy

Thanks for putting this together. We appreciate your hard work.

It would be nice if you could have sent me the comment from your anonymous person so that I might respond to it.

He says:

“I am 59, I was some 233lbs in 2003 and diagnosed as pre-diabetic (FBS of 125)”

125 is not pre- anything. This man had diabetes. I can assure you I never advised this individual to eat any particular level of carbohydrates.

I would no sooner advise that all diabetics can eat potatoes than I would advise the blind to take up motorcycling,,,,

Common sense, people.

PS – I would like to see the blood glucose elevations we are talking about. Even normals may elevate more with a potato than ice cream that’s full of fat!

If you were doing this on a VLC diet without days of carb adaptation beforehand, then these results are normal. Try them after re-adapting to at least 150 g/day and I predict your BG will not peak higher than 120, which would be normal while carb adapted.

Your stated A1c is 5.9 which is normal. A1c is more useful to see the trend than to just read the absolute level. My own A1c is 5.6. My 75 year old father who is not obese and in perfect health has an A1c of 5.9. You were actually diabetic before, so your fat loss seems to have reversed your diabetes. I would be more concerned about fat gain with dietary changes than with BG spikes. Send me an email at paleonu1@gmail.com if you wan to correspond on this outside this public forum.

http://www.facebook.com/profile.php?id=100002023989070 Cris Barrows

That is very useful to know. I had assumed my A1c should be nearer a supposed optimum of 4.6 and had considered 5.9 to be quite high. So perhaps I am not quite so unhealthy after all.

http://profiles.google.com/hemoglobina1c Kurt Harris

A1c is not very predictive on an individual basis below 6.0. It is much more valid as a population measure and to follow improvements in people with diabetes in the ranges above 6.0. A1c depends on average red cell lifespan as well as glycation rate. I have observed anecdotally that people with actual diabetes and seem to achieve lower A1c values more easily with treatment than normal people. This might relate to decreased red cell lifespan reflecting oxidative stress or something. I don;t know for sure, but having A1c of, say, 4.6 may not necessarily be better than higher numbers.

In addition to my own example Stephan Guyenet has blogged that his A1c is the same as mine at 5.6 and he was in his 20’s and had totally normal glucoregulation at the time. I think it is possible that people reading Dr. Bernstein and Junny Ruhl are getting distorted expectations of how low an A1c can be achieved without frank diabetes.

If you are truly concerned about glycation, get a fructosamine level drawn, which is independent of red cell lifespan. Or you an eat your usual meals and do hourly fingertsicks while awake. That is the most accurate way of knowing your AUC for blood glucose. But fair warning, if someone has you convinced that your blood glucose should never rise with a meal (or exercise) you are going to be very confused!

STG

Could you, Dr. Bernstein and Jenny Ruhl discuss this on a podcast? It would be a very lively debate and discussion.

Anonymous

I’m working on something for my new podcast starting in January.

STG

Having read Dr. Bernstein’s book and Jenny Ruhl’s book I think that they would probably have a different perspective than Dr. Harris. Hearing the three of them discuss blood sugar facts and issues would be fascinating, controversial and informative. When people interact verbally with others, the strengths or weakness of their arguments become more apparent, Jimmy, I hope you can set this one up.

Anonymous

I’ll see what I can do

STG

Jimmy,

I am sure you read Dr. Ron Rosedale’s thoughful, intelligent post. A podcast with Dr. Rosedale and Paul Jaminet could explore the relationship of “safe starches” to blood sugar in more depth and with intelligent discourse. Thank you for the wonderful podcasts! They are eucational and informative.

Anonymous

Oh, I have more coming from Dr. Rosedale that I’ll be posting on my blog later today. I actually have an idea to bring these two on my brand new podcast starting in January 2012 to discuss “safe starches.”

http://www.facebook.com/GeoffreyRHamilton Geoffrey Hamilton

Is this experiment isocaloric? A pint of ice cream as over 1000 calories (the cookie dough also has wheat in it, but let’s ignore that for a second). Did you eat a dozen eggs? Did you eat 1000 calories of sweet potatoes and butter? By my count, 10 oz of sweet potatoes is only about 300 calories… Also ditto on Dr. Harris’ point about glucose tolerance on low carb.

http://davidcsonka.com David Csonka

I think it is unwise to frame the discussion from the implied standpoint that everyone is metabolically deranged.

There are so many traditional cultures that consumed starches, and didn’t become obese, that I think the discussion would be better served by recognizing that consuming starch is an inherent human capability. That is what amylase is for after all. There are even some cultures that are commonly misconstrued as low-carb populations which are in fact consumers of copious amounts of starch, ie. Masai (ref. Masterjohn).

It is certainly true that many people are now incapable of consuming large amounts of starch safely either due to years of metabolic derangement or some other health-related effect. But, to extrapolate this to mean that a low-carb diet is best for all is non sequitur.

For instance, the Inuit are commonly used as an example of successful low-carb, and rightly so – their diet was in fact predominantly low-carb. But I’m willing to bet that none of the readers of this blog are Inuit. Regional and ethnographic adaptation to very specified diets is significant. Those populations gained the ability to successfully eat a certain way from years of natural selection.

Remove that culture from the diet they became adapted to and you see obesity and disease sky-rocket. People of European descent don’t seem to be affected quite as severely, as say the Pima, probably because of some degree of adaptation due to widespread agriculture and grain-reliance for the last 4,000 years. However, the further metabolic assault brought on by even more modern food-like products obviously sends even European-descended people over the edge.

We have to accept that the diverse melting pot that is U.S. and other immigrant-based populations means that there is no traditional diet blueprint that can effectively be applied to everyone. It’s a crap shoot. Just because it worked for the Inuit doesn’t mean it will allow you to thrive. It’s certainly a possibility, but your unique blend of DNA and your health history will ultimately determine whether or not it will be a good thing for you.

It sounds like relativism, but really it’s an acceptance of the fact that humans are still incredibly diverse, despite being the same species. Low-carb can be good, high-carb can be good. It all depends. I think the more important factor for the majority of generally healthy people is to eat real food.

It might be wiser to frame the discussion from the standpoint of: are there any safe starches for people who are metabolically deranged?

Anonymous

Thanks David. I never implied that everyone is metabolically deranged. I’m just saying that ignoring this segment and calling foods “safe” for this is difficult.

http://davidcsonka.com David Csonka

I get ya’ Jimmy, I was attempting in a general way to address the low-carb community as a whole, not directly to you.

I think many of the arguments for prescribing a low-carb diet often presume some sort of metabolic derangement – which would be OK, but when the prescription is then extended outward to being the best diet for otherwise healthy people, it doesn’t necessarily follow.

For instance, Cordain seemingly claims that potatoes and rice are simply bad, outright. I just think it would be more instructive to qualify the recommendations based on more individual circumstances. After all, I’m fairly certain that he recommends potatoes in Paleo Diet for Athletes.

Anonymous

I agree in having separate explanations depending on the metabolic health of the patient.

http://weightmaven.org Beth@WeightMaven

A permanent low-carb prescription for those with metabolic syndrome presumes that metabolic health cannot be restored. Perhaps it can, perhaps not … I’d like to see that explored more. In the meantime, I like the premise of having carb intake be proportionate to activity level.

Anonymous

Jimmy, thank you so much for bringing all these wonderful disagreeing minds together to speak their piece. You provide a great service, and play field for thoughts and beliefs and science to be hashed out.

Anonymous

Thank you Fiona!

http://twitter.com/evolutionarypsy Emily Deans, M.D.

Very valuable post. Now I have a good idea of who has a dubious grasp of physiology and who doesn’t. 😉

Anonymous

Thanks for reading Emily.

Andrew C

Jimmy, would love to know more about the affliction of being “metabolically-deranged”. Which doctor diagnosed you with this?

Do you have test results that show you being “metabolically-deranged”?

Are there any studies to read about metabolism becoming deranged? Thanks!

Anonymous

This is the term being publicly used by many in the low-carb/Paleo community, including Robb Wolf, Mat Lalonde and Gary Taubes, for example. I never said I was diagnosed with this. It’s simply describing people (like me) who have obvious things going on metabolically that make it more difficult to control weight and other hormonal responses.

Andrew C

Do you think you have an affliction of “metabolic-derangement” based on other people’s say so? Do you know how they determine if someone is metabolically deranged? e.g. certain blood tests and symptoms?

What are the “obvious things going on metabolically” in your case, Jimmy?Are these things more obviously explained by “metabolic derangement” (what is the definition of this?) or by a simple explanation of calorie input exceeding calorie output?

Anonymous

I think it goes much deeper than calories, Andrew. I’ve fluctuated my calories, carbs, fat and everything else to levels where I should be losing. It’s not happening. If there was just one easy answer to it all, then metabolic derangement wouldn’t exist.

Andrew C

Wait a second.

I am trying to understand what “metabolic derangement” is defined as, and if it exists.

You’re saying that it does exist because otherwise it wouldn’t exist?

Anonymous

Dude, why are we making this a rocket science project? Here’s my understanding of it:

Some people have become so damaged from consuming excessive (mostly refined) carbohydrates that it becomes necessary for these people to limit their consumption of carbs. Hormonally, their bodies cannot respond in the same way that a person who has not become damaged would. That’s why they can’t consume starch without gaining weight or adequately controlling weight.

Andrew C

Rocket science? Surely you jest. Some of you fellows acting as armchair scientists, thinking of scienctific sounding explanations of why you are overweight and why you have trouble losing weight, sound like the ones interested in theorizing about weight gain on the level of aerospace engineering.

While I am the one who asked several comments above if a simpler explanation sufficed.

I’m really just trying to apply common sense to a problem that to most cultures has not been difficult to understand or to have a mysterious cause. Not trying to introduce rocket science here. Many of the above blog post’s contributors have that area covered.

So based on your above reply, is this a summary of what “metabolic derangement” is? 1. excessive (mostly refined) carbs damage a person so that he has to limit all carbs, even unrefined2. one way (primarily?) the person is damaged is hormonally.

Based on your apparent definition of “metabolic derangement”, you conclude: “That’s why they can’t consume starch without gaining weight or adequately controlling weight.”

Can you answer this question Yes or No, keeping in mind that conclusion? If an obese person normally eating 4000+ calories, and who allegedly has “metabolic derangement”, requires approximately 2200 calories a day, and each day only consumes 1500 calories of starch and nothing else, will they gain weight?

I don’t mean if they add ad libitum oil, nuts, lard, or butter. Just 1500 calories of starch, e.g. potatoes. Yes or no, and how does it fit with your conclusion?

Also, are there any studies or tests to show that someone fits your definition of “metabolic derangement”?

Thanks Jimmy!

Anonymous

You bring up so many confounding variables in your response that I SERIOUSLY need a rocket scientist now. I don’t have time to hash through all of this today. I’ll let others chime in if they want to respond to your inquiry.

Have you been diagnosed with “metabolic derangement” and how? How does it apply in a situation where someone undereats calories (where are the confounding variables?). My second reply also had a appropriate question: Are these things more obviously explained by “metabolic derangement” (what is the definition of this?) or by a simple explanation of calorie input exceeding calorie output?Humor and hand waving at an attempt to deflect honest relevant (obvious?) questions weaken your case in the mind of the average competent reader.

Anonymous

Andrew, I’m not deflecting. Just don’t have time to respond as thoroughly as you are demanding. Others can chime in to satisfy your curiosity.

Andrew C

I don’t think that asking how you know you’re “metabolically deranged” and if you have a diagnosis demands a thorough response.

So readers of the blog are supposed to believe low carb (paleo version or not) fails you because you think you have a condition you can’t define from an authoritative source, nor provide a diagnosis showing you have this condition?

Why would they believe low carb would work for them then?

Have a nice day!

Anonymous

I wouldn’t say low-carb failed me at all. Lost triple-digit weight eight years ago, kept off triple-digit weight ever since, improved my lipid panel, and have a heart scan score of zero. If that’s the definition of something not working, then I must be missing something. I’m making no claims about this other than expressing it is a viable theory for why people may struggle.

Andrew C

Thanks for not answering any of the questions.

Since your blood work is apparently good, or at least better, what else may indicate a condition of “metabolic derangement” in your case?

You are the one who says something’s “not working” by asserting you have a “metabolic derrangement” that is keeping you obese. Both of those could be considered failures of a diet, and at the very least one is.

Anonymous

Again, I haven’t failed eating low-carb–down well over 100 pounds and kept off for 8 years and health that is better than most 20-somethings. That’s good enough for me to keep on livin’ la vida low-carb.

Jaytee3

What a troll. Cutting carbohydrates obviously has worked for him. Why are you here, just to be annoying? You don’t seem to be trying to learn anything.

Andrew, you are either a major league troll or you picked a curious time to try and understand why LCers promote a LC diet. If it’s the latter, I recommend Google.

Andrew C

But Google directs me here. Thanks!

http://weightmaven.org Beth@WeightMaven

Then you aren’t very good at Google I guess!

Pooh Bear

Do you mean to tell us, Beth, that livinlavidalowcarb.com is not a very good site “to try and understand why LCers promote a LC diet”? ” Because that is exactly what you appear to be saying.

http://weightmaven.org Beth@WeightMaven

Nope not at all. How many of the blog posts here have you read?

Pooh Bear

I’ve read plenty of posts from this blog. None of them answer the questions Andrew asked above.

Beth, you remind me of Andrew’s quote: “Some of you fellows acting as armchair scientists, thinking of scienctific sounding explanations of why you are overweight and why you have trouble losing weight, sound like the ones interested in theorizing about weight gain on the level of aerospace engineering.”

How’s that pondering over the mysteries of weight worked out for you all these years?

Anonymous

No, we’re not doing that here at my blog.

http://weightmaven.org Beth@WeightMaven

Actually, it’s working out pretty great for me. Thanks for asking!

http://praguestepchild.blogspot.com/ Praguestepchild

How ironic to quote something unintelligible: “sound like the ones interested in theorizing about weight gain on the level of aerospace engineering.” Uhm, what does this even mean?

A line from Pulp Fiction springs to mind.

Jaytee3

Your litany of detailed, obtuse questions is annoying. Go do some googling. Jimmy’s job isn’t to explain everything to you personally.

…

I’d say a good symptom of what gets called “metabolic derangement” is when someone can eat at a level 500-1000 calories below BMR estimates for many weeks/months and not lose fat.

It’s not that calories in/calories out isn’t valid or does not apply, its just overly simple, and some people’s calories out drops like a stone when they try and reduce their calories in without dealing with sugar & carbs first (likely for hormonal reasons) Your obese example might have burnt only 2200 cal while consuming 4k (seems low for 4k in, as most obese people are not gaining 2lbs a week), but what’s being described here would be akin to calorie out dropping from 2200 to 1400-1600 when given 1500cal a day heavy in carbs, and without consciously reducing exercise

If all obese people could lose weight simply by reducing food intake by 30-40% without changing what they eat and just watch the weight melt off then then we wouldn’t have such an obesity epidemic in western society

http://www.facebook.com/profile.php?id=1506613581 Yvonne Mitchell

I couldn’t agree more! I have PCOS. I’ve eaten 600 calories a day for about a year – under a doctor’s supervision. I did NOT lose weight. I went down to 5 net carbs a day, I did NOT lose weight. What is wrong with my body. I have excess insulin, I’ve had at least 3 doctors tell me it would take 3hrs of exercise to burn anything like most people get from 30-60 min of exercise. My metabolism and hormones are screwed up. I am obese and feel I will ALWAYS be obese. Like there is no hope for me. Losing weight while being obese is NOT a simple thing.

Dextery

Yvonne, there are lots of ladies on the Leptin Reset MDA monster thread that have lost weight whereas previously they were stalled, like you. And they do it without any exercise at all. And they are not starving themselves. Quite the contrary, they eat normally and are successful. In fact hard exercise is one of the factors raising your cortisol so you cannot lose weight. There is hope for you but you have to be willing to follow a protocol to the letter.

Good luck to you.

anand srivastava

ten thousand pages of replies. This really is a monster thread. Thanks for pointing it.

http://www.facebook.com/profile.php?id=1040492698 Andre Chimene

Goober Andrew C, your blog should be up by now. I look forward to reading it and all that you will contibute to the health and well being of others. In response to your “what doc diagnosed you…” question…what doc do you know that routinely measures insulin or leptin? What about a test for Mtor? No? Well then, you don’t have all the correct tests to measure metabolism or what is truly going on with your body. I will come out say what Jimmy is too polite to say….shut the hell up unless you want to debate a point or shed light on an issue that has to do with getting your fellow man or woman their health back. You are a heckler shooting insults from the dark, creepy back of the bar. Write your own blog and give us the word from on high of how to obtain perfect health. Pick up a mike, go to the center of the stage with a spotlight shining down on you and preach…other Goobers will be waiting in the shadows, enjoy the ride.

btw, I am playing around with the food reward idea, so far (just one day in) it seems to work. I’m keeping it low carb, tho, for now. If and when I lose the weight I wanna lose (10 to 15 pounds?) I think I’ll add in some starchy foods to see what happens.

Anonymous

This was a subject that needed to be discussed.

http://www.carbohydratescankill.com Robert K. Su, MD

While some people are concerned about recharging the glycogen storage, has anyone ever been concerned about the effect of the level of glycogen storage on the degree of stress hyperglycemia, which is closely linked to the risk of acute heart attack and stroke? How to avoid a surge of blood glycemic level under stress is the key to avoiding an acute mishap.

http://www.blackhairinformation.com BHI

All I know is that a potato satisfies me longer than any food bar none. Even a 8oz steak with 2 tablespoons of butter never came close. Does my blood sugar climb after a potato meal? Of course but that’s what blood sugar is supposed to do! As long as it stays up for just a few minutes before dropping to normal levels again then your body’s working fine. All this obsessions with panicking because blood sugar is over 100 after a meal. The pancreas isn’t there for decoration purposes. It’s there to do a job. Let it

http://www.carbohydratescankill.com Robert K. Su, MD

Do you mean after eating a potato, you would not feel the need of food again for a period, which was longer than the period after eating an 8oz steak with 2 tablespoons of butter? How big is the potato you ate? Sure, the pancreas is there to produce insulin for regulating the blood glucose level. However, the pancreas is not there to handle whatever amount of carbohydrate, which we dump into our stomach, and is still in good shape. Diabetes mellitus is not really a genetic disorder.

http://www.blackhairinformation.com BHI

Precisely. If memory serves, it was about 2 hours later that I was genuinely hungry again after the steak. I’ve also drank a 70g protein shake in the past with similar results. It’s results like these that makes me believe that obesity is not caused by the same thing in all of us. Don’t get me wrong, I don’t get the same satiety from all starches. I could eat rice as an Olympic sport and still have room for more! This is why I think the food reward theory has merit, while I don’t care much for french fries, I can leave some on my plate, someone else will eat them and immediately crave more. I know diabetes isn’t a genetic disease but it’s not all about carbs. There seems to be a high carb, high fat, wheat and vegetable oil sweet spot in which type 2 develops.

http://www.carbohydratescankill.com Robert K. Su, MD

Thank you very much for your details. By the way, did you just eat a plain potato or adding something like butter or else to the potato. Is it a large or medium size of potato? Some people do feel fullness of stomach such as gas in the GI tract after eating potato.

http://www.blackhairinformation.com BHI

No butter, just potato and baked beans. Pretty high GI but low reward (for me anyway).

Anonymous

Lowish carb is how I originally lost weight and how I maintain it where I want it. My N=1 is that starch in any form dysregulates my appetite and drives me to overeat. So, for me, safe starch is a little starch (typically, one or two sushi rolls) eaten no more than once a week.

Anonymous

Johnny, I appreciate your feedback, but posts like this are the exception not the rule. And with a topic like this, it needed to be thorough. I make no apologies for putting in the effort to make this post valuable to my readers. You don’t have to read it in one sitting. Read a little here and there until you’re finished. You’ll be glad you did.

http://www.facebook.com/profile.php?id=1436470114 FatThen FitNow

Hi Jimmy, Thank you for asking me to weigh in on this issue. As always your site is the premier destination on the web for not only low carb info, but low carb conversation. I am honored to be included by you and with a group of such distinguished other members of the low carb community.

Joe

Anonymous

THANKS Joe!

http://profiles.google.com/matthew.brody Matt Brody

Johnny, today’s post IS a post from a few different health blogs! Read it like you’d eat an elephant – one bite at a time

http://profiles.google.com/matthew.brody Matt Brody

You know that is a good point. Most of the top hits on that term are from the paleosphere. “Impaired glucose metabolism” is probably a better term. I’ve edited my reply to reflect.

http://malpaz.wordpress.com/ Mallory

but meaningless data, you eat VLC….kinda like when people switch from SAD/western diet to eggs with coconut oil, they get the sh*ts… it takes a bit of adjustment time… i think thats why rosedale starts people with long chain 3 and MUFA, to give the body time to adapt to fat burning. same works for carbs. jumping into a bowl of cheerios proves nothing…

http://www.carbohydratescankill.com Robert K. Su, MD

Well, these data are meaningful to me.These test participants were not on any diet at all. The food items, which they took for the tests were those they had taken in their ordinary life. There is no need of a period of buffering prior to these tests. The test results show how each food item affect each individual’s blood glycemic level after consumption. A merely normal fasting BG does and/or 2-hour postprandial do not tell the whole story of the individual’s health.

Jonharting

People adapt to different diets and it doesn’t happen instantly. Pancreatic glucokinase gets down-regulated in response to a ketogenic diet. Higher than average levels of circulating palmitic acid cause peripheral insulin resistance. If a person eating like this (i.e. VLC) gets hit with a bolus of glucose, whether it’s from an OGGT or a bowl of cheerios, they will “fail” the test but it’s clearly not pathological. The body is merely sparing a smaller pool of glucose for the brain.

The digestive enzymes respond similarly too. If you’re eating VLC, you’re likely producing higher amounts of lipase and less amylase. The body adapts to different ways of eating and needs at least some time to readjust to a new one.

http://profiles.google.com/hemoglobina1c Kurt Harris

Nice reply. Your gut biota will need time to adapt to resistant starch as well.

John Lushefski

I’m a bit surprised about how, as Emily says, “dubious” I’ve found many of these contributors to be. Several of these old repeated arguments (we shouldn’t eat more glucose than is in blood; glucose isn’t an essential nutrient, so don’t eat it; etc) make little sense or have little support. It is quite obvious that many are unfamiliar with Paul’s overall work and tone as well. While I may not agree with everything Paul says, he doesn’t make ridiculously adamant claims like many others, and he continues to develop his own plan and ideas.

To anyone interested, although he didn’t contribute here, Lucas Tarfur actually has the best and most thorough criticism of Paul.

Melissa

My mom’s oncologist told her to eat lots of healthy whole grains…which is sadly probably the convention among such doctors. Both of you would probably be controversial among them.

Anonymous

I take on controversial subjects in posts like these about 2-3 times a year. It is critical to gaining an understanding of the concepts that aren’t so black and white.

Vanessa Romero

I agree with Mark Sisson’s take, “I see an unnecessary trend towards differentiation in the ancsetral/paleo/primal/lowcarb world. We are somehow trying to find all the ways we are different (which only confuses people) rather than identifying all the ways in which we are very alike and aligned, and then understanding the subtle differences that remain”.

Katherine Morrison

(nonexistant)God, I love Mark Sisson.

http://malpaz.wordpress.com/ Mallory

Why wasnt the opinion of Lucas Tafur invited inthis discussion. he at least has a very specific understanding of science and what he believes….

http://www.facebook.com/profile.php?id=1115202741 Katherine Morrison

It was an open call, really. Lucas could have replied if he had the time, interest and/or awareness.

Mary_lee_fultz

LOL! Jimmy, I LOVE how Dr. Bernstein had the last “say” and coming from a world renowned expert in the field of diabetes…AND being a living example of incredible health with the “law of small numbers”…his opinion mattered the most. I burst out laughing when I saw his comment. Sometimes, “less is more” and Dr. Bernstein had a nice way of showing us all that.

On another note, I noticed the new movement toward Paleo nutrition and it seems like far more carbohydrate than a typical human could possibly forage for in a day (i.e. approx. 150 grams of carb.), most particularly in the arctic. Thus, I just feel that yet another promising dietary philosophy based on meat, just got a pita wrapped around it. If matabolicalloy damaged/diabetic, 150 grams of carbs per day is going to damage blood vessels over time, due to high and low blood surges. And hey, if the traditional human ‘could’ forage for 150 grams of carbs per day (although I’m still stuck on the image of the Inuit coming up with that number…), well certainly, they didn’t have type I and II to contend with and could probably handle that number. Our modern day prototype “can’t”. End of story.

http://www.carbohydratescankill.com Robert K. Su, MD

While some are concerned about recharging the glycogen storage, has anyone ever been concerned about the effect of the level of glycogen storage on the degree of stress hyperglycemia, which is a risk of acute heart attack and/or stroke? To prevent an acute surge of blood glucose is the ley to avoiding an acute mishap. For your references: please google (1) Stress Hyperglycemia, Inflammation, and Cardiovascular Events. (2) The Effects of Carbohydrate Variation in Isocaloric Diets on Glycogenolysis and Gluconeogenesis in Healthy Men.

http://pulse.yahoo.com/_6ZPXB5DBFDYKX36DEYLTOH6XM4 Space Vegetable

Wow, great info! I think the biggest takeaway for me is that we’re all different and need to adjust our carb intake (“safe” or otherwise) based on our own results and individual chemistry. I found Dr. Shanahan’s comments on food allergies particularly interesting, since I myself have allergies to a lot of these frequently-modified foods (potatoes, corn, soy, most legumes, tomatoes, etc…).

I’m in the process of revising my diet, since I’ve been a bit lazy about it lately. I’m going to try eliminating wheat entirely to see what kind of effects it has, since I’ve been noticing increased arthitis activity (rheumatoid) following days when I fall off the LC wagon and eat pizza, cake, cookies, etc. I do think the Jaminet diet is better than one full of processed junk and refined grains, but I’m very skeptical about the inclusion of such heavy-duty carbs as potatoes and white rice. My own experiences, allergies notwithstanding, show less-than-optimal results from consuming those particular starches. I do include winter squashes and sweet potatoes/yams in my diet in small quantities simply because I like them and they contain some good nutrients, but the levels of total carb intake recommended are far too high for me.

Thanks for bringing up this discussion along and for the large variety of opinion. It’s important to get the information and discussions out there so we can all stay informed.

http://profiles.google.com/hemoglobina1c Kurt Harris

What the hell are you talking about? What cancer patient?

I don’t treat cancer patients.

Oncologists at grand rounds are on board with all your ideas and are treating cancer with diets now?

Are you insane? Practicing in bizarro world?

Jack, all the laughing is among the respectable paleosphere bloggers, who are laughing at you behind your back in our private emails.

You are a quack. Stop attacking my qualifications to blog. You know nothing about me.

Jack Kruse DMD,MD

My comment directed at you and paul were based upon the recommendations to feed amcancer patient carbs which stimulate the IGF1 pathway…….no where in my answer to jimmy’s email did i mention a normal healthy person. My response was recommending carbs to a cancer patient. Paul’s blog was an anti cancer blog. If you actually read what i wrote that would have been clear. This is why i mentioned in my answer i showed his blog on this issue and your responses to our oncologists to peruse. My reading of the literature and my training are consistent with a very low inflammatory diet and low in IGF1 signaling. You might have generalized my comments to include normal folks but my criticism was specifically related to cancer patients eating carbs once their diagnosis was made. The literature is clear on this. Paul suggested a higher carb load for these people and you seemed to agree with this. I don’t and neither do most other cancer researchers based upon the published data. I think people need to question anyone who advocates carbs with newly diagnosed cancer. That was the point of my criticisms

http://profiles.google.com/hemoglobina1c Kurt Harris

Maybe YOU should read more carefully. Nowhere in my response to Jimmy do I mention cancer treatment! I indicated every point of agreement I have with Paul in my answer to Jimmy and that is what it would be fair to you to comment on.

And my understanding is that Jimmy asked your opinion of Paul’s ideas, not mine. So why mention me at all if I said zero about cancer?

I personally would follow Seyfried and do a 10 day water fast upon diagnosis (before any chemo or debilitating surgery) followed by a ketogenic diet aided by coconut oil if I were diagnosed with cancer. I’ve said this in comments here and there but not blogged on it. So you would have no reason to ascribe any particular dietary recommendation to me other than this.

“my criticism was specifically related to cancer patients eating carbs once their diagnosis was made. The literature is clear on this. ”

This is an outrageous claim, actually. It is typical of your pronouncements. Asserting that things which are speculative (even if reasonable) are well established or “clear”..

“Paul suggested a higher carb load for these people and you seemed to agree with this. I don’t and neither do most other cancer researchers based upon the published data.”

Go ahead and name only 10 clinical cancer researchers that advocate very low carb or ketogenic diets as a treatment for cancer. That should be easy if “most” are recommending diets to treat cancer that are at odds with Paul’s recommendation.

http://praguestepchild.blogspot.com/ Praguestepchild

Also has anyone mentioned that Shou-Ching “is a molecular biologist and cancer researcher at Beth Israel Deaconess Medical Center and Harvard Medical School”? I’m not sure how much input Paul’s co-author and better half had on the cancer/carb post on PHD, but I seriously doubt it was negligible.

http://twitter.com/evolutionarypsy Emily Deans, M.D.

I have several patients with cancer who go to the Dana Farber Cancer Institute (DFCI) in Boston for treatment, and I teach a class at Harvard Medical School with a psychiatrist who is the head of the psych-oncology service at the Dana Farber. None of my patients were recommended a ketogenic diet by DFCI, though my co-teacher was intrigued and mentioned they are researching ketogenic, vit D, etc. at DFCI, though as far as I know the most evidence is in favor of ketogenic diets are in brain cancer, which would make sense, given the brain’s unique glucose needs and thus deranged cancerous brain cells perhaps being more vulnerable to glucose restriction than most.

I know that Paul Jaminet has done quite a bit of reading on cancer and diet – it is a particular interest of his. He makes the (obvious) point that many cancers are very different, and thus might respond differently to different diets. Some cancers are clearly the result of viral infection (this is not controversial – think karposi’s sarcoma), for example. In others that is not as likely.

Personally I would fast upon diagnosis if I could, and I make fasting a fairly regular part of my lifestyle. Once I had a specific diagnosis, and particularly during various types of treatment (radiation, types of chemo, etc), nutrition needs would probably vary, and I would likely steer my reading to the particular type of cancer identified, and the particular treatments.

http://profiles.google.com/hemoglobina1c Kurt Harris

Hi Em

When Kruse says:

” You are in denial of some serious level one peer reviewed data that is extremely well accepted across every medical specialty. So i think anyone consulting you on your diet recommendations with cancer should do their due diligence and get another opinion. I am quite sure most other opinions wont be similiar to yours.”

What serious level one peer reviewed data “that I am in denial about” is he talking about? Is this guy really claiming that ketogenic diets for cancer, even brain cancer, have been vetted by the Cochrane collaboration? I have honestly never met an oncologist in person that even recommended anything other than usual diet and supplements.

I am quite familiar, as you are, with the extant literature on ketogenic diets for cancer. The only time I ever did “put someone on a diet” for cancer, it was a friend with GBM and I recommended a ketogenic diet including coconut oil. The neurosurgeon and the oncologist were cooperative but indifferent to my dietary recommendation. She is doing very well 3 years after diagnosis, incidentally, but she did not follow the diet for any length of time.

I might be one of the handful of physicians outside of research settings that has even recommended or tried to treat GBM with a ketogenic diet, so this bizarre case of blogosphere fratricide is really puzzling to me. Just feather-fluffing to garner attention I guess.

http://twitter.com/evolutionarypsy Emily Deans, M.D.

Kurt, I’ve not reviewed the literature with the exception of a couple of papers. I’ve also found oncologists to be very friendly to alternative treatments as long as they are not wacky or dangerous (at DFCI, they have therapeutic massage, support groups, and Reike practitioners as part of the offered treatments).

I don’t personally know any oncologists who recommend a ketogenic diet. My current patients treated at DFCI have had adenocarcinoma of the lung, testicular (stem cell) carcinoma, rectal carcinoma, and melanoma. However, the backroom buzz is that they are excited about the possibilities of ketosis.

The only cochrane review of a ketogenic diet is for epilepsy.

Anonymous

I’ve read vociferously on diet for thirty plus years–and so learned that lots of supposedly knowledgeable people make lots of unsubstantiated claims– and tried the healthy whole grains route, vegetarian, even vegan diets, exercised faithfully, and for ten years tried everything to drop weight, but as long as I eat grains or fruit besides berries, I will crave constantly and be miserable. No doubt some people can even live on twinkies and milk, but most can’t. I just can’t see how a diet that includes regular amounts of carbs humans did not evolve to eat can make sense for anyone, especially anyone who is struggling with weight.

Anonymous

And once you struggle with weight (and other metabolic issues), it’s hard to justify eating as if nothing is wrong. You have to make necessary changes and restricting carbohydrates is a part of that for many.

Anonymous

I’ve been doing PHD for 6 months after 45 years of eating the SAD. I wasn’t super overweight, but was gaining every year, 6′, 200 lbs. I craved sweets. Six months later I am down to 180. I eat rice and sweet potatoes but don’t crave them, never crave sweets, don’t think about food all the time like I used to. Try it yourself and see.

Anonymous

Glad it worked for you buddy. Congratulations!!!

GalinaL

It is also important because we do not live alone. I, for example, cook for my family and my husband and son can eat carbs without gaining weight. Everybody in my family is having problem with allergies. Recently my 18 years old son suggested that he, probably, also should eat VLC because he noticed it eliminated my need for asthma and eczema medications. I advised him to try something like Dr.Kurt G. Harris recommendations first. I must admit, my diet worked for allergies better, but I hate to restrict young lad’s diet too much.

http://weightmaven.org Beth@WeightMaven

If we didn’t evolve to eat carbs, where did our ability to secrete amylase in response to dietary carbs come from?

GalinaL

What if we indeed evolved to eat carbs, but some of us somehow cant eat carbs without getting fat? It could mean some of us evolved to get fat as well, especially middle-aged females. It is not what I want even though it is may be natural for me.

http://weightmaven.org Beth@WeightMaven

If LCing works for you, that’s great. Lots of folks have initial success with it, but then stall or regain. And still others just have difficulty eating LC in our modern world. Me, I think there’s something more at work than just the amount of carbs in our diet.

Anonymous

Starchy tubers are not inconsistent with an evolutionary diet, and we do have the ability to digest starch. Of course, that doesn’t mean every individual has the ability to handle a starchy diet. I’ve had wonky carb metabolism since I was a small child, and my life history and more recent dietary experiments all point to an absolute need to avoid starch for the most part.

Anonymous

And that’s why labeling starch as “safe” is misleading. This is one of my biggest concerns about this concept of “safe starches”–it gives the green light to ANYONE to consume starch when they might not be able to without consequences.

http://weightmaven.org Beth@WeightMaven

Why does the idea that some starches are preferred over others in a non-LC diet (such as paleo or PHD) concern you? Why wouldn’t a LCer look at Paul’s recommendations the same way they would Dean Ornish? I.e., this guy promotes a diet different from LC. That said, if Dr. Lindeberg’s research is correct, then even a LCer might benefit from utilizing safe starches as part of their carb intake, no matter what it is.

Katherine Morrison

The term “safe starch” is meant only to distinguish between the less biologically appropriate starches from the (possibly) more biologically appropriate starches. You continue to frame this (yes, frame) as if the recommendation for safe starches applies specifically to those who cannot tolerate them.

Doesn’t is seem reasonable that those who cannot tolerate them *know* to stay away from them? Are people really this clueless?

Anonymous

Yes, sadly, a lot of people are “clueless” and want to be told what to eat. That’s why the notion of “safe starches” is dangerous IMHO because it gives people permission to consume something that may or may not be helpful to them.

http://profiles.google.com/hemoglobina1c Kurt Harris

There are also legions of people who think all carbohydrates are a barely tolerated poison, but whose health and well being might be better if they ate them than not.

Anonymous

That’s why I wrote this post. 😉

http://www.facebook.com/profile.php?id=1115202741 Katherine Morrison

So your issue is with the term “safe-starches” rather than the concept? (assuming all approrpriate dislaimers are in place..)

Anonymous

Yes.

Occam

Jimmy, I’m sorry to say it but your claim sounds disingenuous to me. If your problem with safe starch was truly limited to simply clarifying the definition of the phrase, you surely would’ve mentioned it somewhere, anywhere in your framing of your lead-in argument and solicitation of input by the “experts.” Only now that you’ve received significant challenges and less than positive feedback from your readership has this very thin claim surfaced.

I am a newcomer to your blog, though I have been part of the Paleo world for nearly a year, and I have to say that I am dismayed by what I’ve found so far.

Anonymous

I appreciate your feedback, but you don’t know my motive for writing this post. I’m surprised that so many people have taken it as a personal attack against the Jaminets and Paleo dieters. Anyone who knows me would tell you that is absurd. I’ve always been about education and finding answers to difficult questions. Am I never allowed to ask questions that I think are important to discuss? Preposterous. I will never stop the pursuit of truth.

http://weightmaven.org Beth@WeightMaven

Jimmy, you’re allowed to ask all the questions that you want; I don’t think asking was a personal attack. But the responses? Another matter entirely. One thinks Paul is a nut job, another thinks his recommendation is “another form of zealotry” and another thinks they should be reported.

So yeah, those of us who have great respect for the Jaminets and/or greater familiarity with the concept of safe starches than the folks who answered the questions might have an issue with these responses.

Anonymous

I can’t control how people respond. I can only ask the questions.

http://weightmaven.org Beth@WeightMaven

Perhaps. I’m just surprised that you’re surprised by the response.

Anonymous

I’m surprised by why people would object to simple questions being asked about a critical topic of discussion.

http://weightmaven.org Beth@WeightMaven

I don’t think most folks objected to the questions.

Anonymous

True…at least here on my blog. Thanks for your input.

http://profiles.google.com/hemoglobina1c Kurt Harris

Nonsense. You can first pick people with expertise or training (Tom Naughton?) and you can screen out people who obviously put zero effort into understanding what he Jaminet’s even mean by the term “safe starches”.

Elenor Snow

You mean screen out a huge proportion of Jimmie’s usual audience? I am ever-so-slightly a food and nutrition geek (and I love your blog, Dr. Kurt) — but I cannot possibly read them all, nor all the books. And reading in passing that rice isn’t so bad gave me some hope that I, too, could eat rice. And I can’t.

Now I understand, from the discussion here, that Paul Jaminet didn’t actually *mean* me, or people like me, at all! Jimmie’s right: proclaiming there is “safe” starch requires questioning and discussion — because it turns out not be “safe” for a lot of folks. NOW, I understand some of what Jaminet means by safe starch — and he doesn’t mean safe for me!

Elenor Snow

Clueless? You mean because SO many people speak and write so highly of Paul Jaminet (who, I guess, is the one who started pushing this “safe” starch concept?), that therefore I should already know that *I* should not go along with his ideas? (Because he is NOT writing to people with my metabolism type?) I should take advice from some of the ‘leading lights’ out in the LC/paleo/primal world — but should somehow already *know* that Paul Jaminet is not intending to advise ME? You sound as if all of us out here should already know (how should we know?) that his “Perfect Health” is not perfect for us? And if we don’t already know that his advice is intentionally and specifically NOT directed at us, that’s somehow our fault? WE are clueless for not being able to suss out who he means? (And that he does not mean us?)

http://profiles.google.com/hemoglobina1c Kurt Harris

Yes, I can’t disagree with that.

http://www.facebook.com/davidmholmes David Holmes

This is necessary discussion for our time, although quite divisive as Sisson pointed out. I think it may be beneficial to frame the discussion around the different relevant cohorts. Such as people with low-glucose needs (diabetic/metabolically-deranged), average/normal glucose needs, and high-glucose needs (athletes, endurance training).

Anonymous

Unfortunately, that’s harder than it sounds…too many people want blanket recommendations about what to do and don’t want to be categorized or individualized. If something works for one person, then they think it should work for them. It doesn’t work that way.

http://profiles.google.com/hemoglobina1c Kurt Harris

Peripheral insulin resistance is high on VLC. If he does not eat that amount of carbs per day, his BG will look pathological just due to the adaptation to VLC. This is well established in the literature. The most recent meal is most important, but generally 150 g for 3 days will normalize the BG response. Otherwise, the “test” will be false positive.

And yes, I’ve tested my BG extensively it is always normal.

http://www.carbohydratescankill.com Robert K. Su, MD

I understand what you are talking about. However, based on what I understand that people with VLC or LC will have better sensitivity of beta cells for producing insulin in response to BG. For example, I took a cup of plain Cheerios along with a glass of water and had BG tested every 15′. My BG was 101 mg% at fasting, 161 mg% at 30′ point and about 180 mg% at 45′ but came to down to 113 mg% at 75′, and 106 mg% at 105′. Did you take a serial BG tests? If you had, do you care for sharing? If not, could you share with me by e-mail, which is list on my website?

Personally, I like the idea af white potatoes as a “safe starch”. We can grow them organically (as we do our beef) but it is easier and more socially acceptable to top up my energy needs with a delicious potato smothered in butter than to finish tomorrow’s leftover roast, grill another sirloin or ruin tea with a hastily cooked sausage or two.

Anonymous

If only we all had that luxury.

abdurbrow

I’m a big proponent of following closely what happens with your own body and watching the correlation between your dietary intake and the results. One of the foods that always causes me to gain weight is potatoes of any kind, sweet potato, white potato, it doesn’t matter. I personally have a real problem with them. Inversely, I can eat pot roast all day long and not have an issue (other than having big a smile on my face, especially if it has fresh rose mary from the garden.) Rice is equally offensive according to my digital bathroom scale. I don’t eat any commercial meats very well either. Steel cut oatmeal seems to be ok in moderation. Quinoa and lentils seem to be ok in moderation. But, 600 calories/day??? Unlikely. 6 eggs a day seems to be fine. Commercial mayo made with soy oil or corn oil makes me plump. Conversely, I can eat full fat ice cream. I often lose weight after that. But, it must be organic otherwise I plump up. Skipping meals seems to be fine now that my metabolism switches to fat burning without any big issue, my hypoglycemia is pretty much a thing of the past.

I do best eating my starchy foods in the morning after my fasted cardio workout. I try to front load my calories, get plenty of eggs, coconut oil, starch (oats or lentils.) and maybe a small fiber brownie (home made) in the morning. Lunch is 2-4 oz of fruit (nectarine or some berries on a big salad with some oils on top. Dinner (if I’m eating it.) is plenty of rich protein and some squash. I skip dinner 2-3 x/week. I’m still a work in progress. I’m not a perfection, but I’m not 258 lbs anymore either, I’m down to 188 and thats a miracle.

Melissa Hartwig, Whole9

Jimmy,

I appreciate the round-up on this subject – it’s clear we’ve got plenty of differing opinions based on experience, context and background. However, I do agree that including “reviews” of the Jaminet’s discussion on safe starches from those who hadn’t read the book in its entirety was in poor taste. As we’ve been saying a lot lately, context matters. The context of the Perfect Health quotes pulled from the book matter a great deal, as does the context of an individual’s own metabolic and health status and the context of the very word “safe.”.

We think of those foods – white rice, white potato, tapioca – as “safe” starches from a GI perspective, as they don’t directly promote gut permeability or systemic inflammation. Whether they are a “safe” (translate: healthy) choice for people to include in their diets on a regular basis depends entirely on context, as a few of your panel responders here elegantly demonstrated.

Best, Melissa Hartwig Whole9

Anonymous

I simply asked for feedback about the concept of “safe starches” from a variety of people. There was no I’ll intent directed towards Paul or his plan. My purpose wa to ncite discussion of a critical topic. And that’s exactly what has happened. The low-carb community deserves to have questions like this addressed so we can further our knowledge. Thanks aga Melissa.

Meuble

Well said, Melissa. Speaking as someone who was “done in” (adrenal fatigue and completely out of whack hormone panels) by long term vlc dieting and intermittent fasting, I really appreciate the work that the Jaminet’s (and a whole lot of other folks, including you guys over at Whole 9) are doing for putting things in perspective.

Anonymous

I’m not saying I don’t respect their work. But their recommendations are not universal for all.

Katherine Morrison

Nor do they claim that they are.

Anonymous

I would have preferred answers that addressed the merits of “safe starches” as well, but you can sense the frustration of those answering with the thought of such a concept for everyone.

http://praguestepchild.blogspot.com/ Praguestepchild

C’mon Jimmy “the frustration of those answering with the thought of such a concept for everyone”? I don’t think I’m the only one to lose respect for people like Rafnskov and Bernstein for giving such dismissive answers. Paul Jaminet is a very deep thinker on this subject (and I assume his wife is no slouch either), they are in no way deserving of childish flippishness.

Meuble is right, they really are the good guys. Frustration is one thing, but these short, petulant responses are altogether something else.

Edit: In other words, you aren’t responsible for anyone’s response, of course, but I don’t think a rude or flippant response should be justified.

Anonymous

A good reporter shares all without filter. Readers are smart enough to use the information in a way ti benefit them.

http://praguestepchild.blogspot.com/ Praguestepchild

And you are a great reporter, Jimmy. This post is a terrific roundup of opinions and you are responsible for it. Thanks.

But that wasn’t my point.

Katherine Morrison

Most of the respondents were unfamiliar with the Jaminet’s work and responded accordingly based on a summary that lacked sufficient detail and nuance. The result is a collection of answers that are, taken on balance, not very helpful.

Anonymous

I disagree. There are basic principles here that were able to be shared regarding the concept of “safe starches.”

http://praguestepchild.blogspot.com/ Praguestepchild

Probably based on a very brief, how full of shit is this perusal, I agree. The less dismissive answers come from people who are aware that PHD and the Jaminets are not some fly-by-night hucksters.

Anonymous

Hopefully my inquiry puts the Jaminet’s work in front of these key minds in the low-carb/health world.

http://praguestepchild.blogspot.com/ Praguestepchild

I definitely think this controversy is a good thing 😉

Anonymous

The discussion of it definitely is. That’s why I wrote the piece.

http://www.facebook.com/profile.php?id=1115202741 Katherine Morrison

Indeed, but I have say that I’m with Melissa Hartwig on the handling of the whole matter.

http://www.facebook.com/profile.php?id=1115202741 Katherine Morrison

Indeed, but I have say that I’m with Melissa Hartwig on the handling of the whole matter.

Anonymous

It’s all good.

pam

wow. suddenly i lost a great deal of respect for some well known names, too.

regards,

Katherine Morrison

How on earth though, Jimmy, would they get the idea that the Jaminet’s recommend that for everyone. Have you read his blog posts?

Anonymous

But without making a distinction about the use of the phrase “safe starches” for people who are metabolically deranged or damaged in some way leaves the wrong impression. That’s why I don’t think they should be called “safe” because it will green light everyone to try them. When I asked Paul whether these starches are “safe” for everyone on my podcast, he affirmed that they are.

http://praguestepchild.blogspot.com/ Praguestepchild

Not to double team you or anything, Jimmy, but I think Paul Jaminet is all about making distinctions.

Anonymous

It’s cool. In this flash pan society we live in, these distinctions can seemingly get blurred.

http://weightmaven.org Beth@WeightMaven

Well, they are “safe” … the question is the amount, right? I don’t know that he’s advocating everyone can eat these safe starches to abandon (especially since he only recommends 100g/day, which is not really that much more than your garden variety LCer takes in who isn’t trying to zero carb or maintain purple stick ketosis).

Anonymous

But the difference in the carbs in white rice compared to lots of green leafy or non-starchy veggies is immense. You can get better quality carbs from vegetables.

http://weightmaven.org Beth@WeightMaven

Well, what you can get with other carb sources besides white rice is get some other nutrients along for the ride (I think Kurt Harris makes a good point re the nutrient load of potatoes). But it’s not like you cannot eat veggies on PHD and have it both ways.

Anonymous

And the regular consumption of veggies by low-carbers is hardly ever given credence.

http://profiles.google.com/hemoglobina1c Kurt Harris

That is why we eat white rice. It’ hard to get enough fuel fuel just from leafy greens, even if we eat them for the vitamins..

Anonymous

I’m fueled by the fat in my diet when I reduce my carbohydrate intake.

http://profiles.google.com/hemoglobina1c Kurt Harris

But you were asking why we eat it – for the same reason you are eating the animal fat you eat. For fuel. Animal fat and starch are both fuel.

I think the fact that we evolved to be able to digest carbs shows that they were evolutionarily useful, especially in the fast metabolising required for fight or flight activities. And a study Dr. Eades posted on Twitter* shows that modern HG societies do make liberal use of carbs: “Hunter-gatherer diets were characterized by an identical carbohydrate intake (30%-35% of the total energy) over a wide range of latitude intervals (11°-40° north or south of the equator).” That’s a lotta carbs for a lotta the Earth. I think your point is also valid that man has also adapted to a very low carb diet as well. But the question to me is is it necessary to live like an Inuit for health? I remain unconvinced!

Jimmy, we are all fat- adapted all the time. And one needs a good reason to think it is better if the implication is never eating any glucose and forcing your liver to make it from expensive protein.

Anonymous

So we are simultaneously using both fat and carbohydrate for fuel? Is it at the same rate? Doesn’t your body need to use the carbohydrate fuel source before it can tap into fat metabolism?

http://profiles.google.com/hemoglobina1c Kurt Harris

Your brain is never not using glucose, even in the deepest state of starvation or ketosis. Lifting heavy weights fast is using more glucose. Much of your fat oxidation is at lower levels of activity and is happening all the time. But briefly, yes, you are always using both and there is no way around it. That’s why it makes perfect sense to eat some of both, but never in a combination that puts you into energy excess.

Excess caloric intake drives fat storage. Food quality and food reward effects and toxins drive consumption, and these mediate fat gain via energy excess. But without an energy deficit there is no fat loss. There is simply no way around this fact.

Anonymous

So a restricted calorie, high animal fat, high-starch diet is optimal?

http://profiles.google.com/hemoglobina1c Kurt Harris

Optimal for what? If you are talking about fat loss, the optimal diet provides enough protein to be be protein sparing and is otherwise whatever you lose fat on, whether it is LC, LF or bland liquid food through a straw.

http://www.facebook.com/profile.php?id=1506613581 Yvonne Mitchell

I guess I’m doomed to eat 500 or less calories a day to lose weight then? I followed a strict doctor-supervised diet of 600 calories a day and lost NOTHING. My hormones are so screwed up and metabolism must be so entirely slow that I basically need NO energy. I’ve had several doctors describe my body/metabolism as someone who lies in bed all day. I work sometimes 100hrs a week AND go to school. I know I’m not lying in bed. PS – I was INCREDIBLY hungry on this diet – my drive for consumption was from lack of food, not food quality or reward.

Drew Stearns

A damaged metabolism cannot prevent you from losing weight if you’re in a caloric deficit.

A damaged metabolism CAN affect how well you feel, which impacts how physically active you are, which impacts how many extra calories you expend on top of simply existing.

http://profiles.google.com/hemoglobina1c Kurt Harris

I would accept that we should always preface our recommendations with a warning to the metabolically damaged if I could be confident that anyone knows exactly what “metabolically deranged or damaged” actually means.

I accept that diabetics should be careful. Who would disagree? But if we mean diabetes or metabolic syndrome (hypertension, hyper TG, documented impaired GT) then why not just say so?

But are we to think that anyone who is or ever has been obese is metabolically damaged? Or anyone who cannot lose fat on a particular ad-lib diet?

I would order the “metabolically damaged” screening test on myself if there was one….

Anonymous

If this didn’t exist, then how could stubborn body fat loss struggles be explained but as a metabolism or hormonal issue? I agree the diet should reflect the specific health condition of the individual, but that may mean to do with “safe starches.”

http://profiles.google.com/hemoglobina1c Kurt Harris

I am not saying it does not exist, I am asking how it would be defined if it does exist. How do you know you have a damaged metabolism exactly.

If the definition is difficulty with weight loss, and not diabetes, I would need to know why that would mean that starches could not be eaten.

Anonymous

Perhaps exhibiting any of the markers of metabolic syndrome being awry is how to best judge if there is metabolic damage. Multiple markers out of whack determines the severity. And that’s not to say that it’s impossible to reverse this condition if it does exist.

http://profiles.google.com/hemoglobina1c Kurt Harris

Then let’s just use the medically accepted term metabolic syndrome in lieu of metabolic derangement or damaged metabolism, to improve communication. And of course not everyone who is obese or can’t lose fat has metabolic syndrome, nor is metabolic syndrome by definition irreversible.

Anonymous

This is true. I’m still concerned with the use of the phrase “safe starches” because people will think that is universally true–and it may not be. Perhaps calling them “potentially safe starches” with the caveat that you should be checked by a physician to determine if they are safe for you or not would be better.

http://weightmaven.org Beth@WeightMaven

The point is that they are “safe” starches because they aren’t problematic from an evolutionary perspective (as grains are). This is clear from most paleo discussions and from the larger context in Paul’s book.

If someone wants to LC, the biggest issue re starch is a volume one. You don’t get as much for your 25g of potato carbs compared to non-starch sources. And not sure the average doc would be aware that some research is showing better BG control on these safe starches compared to other grains! (Ref the Lindeberg paper I linked to elsewhere).

Anonymous

I’ll be testing this.

http://profiles.google.com/hemoglobina1c Kurt Harris

Well as pointed out by Beth below, they are called “safe” because they are whole foods sources of starch and are not grains, legumes or loaded with fructose.

And I must say I object to the default presumption that starch is dangerous. Why not qualify the safety of fat? Should our dietary fats be physician approved? Even our beloved animal fat is dangerous if it leads to caloric excess, and yes, I see plenty of this clinically.

Anyone who is eating a lot of fat and is gaining fat or not losing it is damaging their metabolism just as surely as if they did it with high carb intake, and definitely more than if they ate high carb at a hypocaloric level, whatever the particular diet they are using to achieve energy deficit.

If LC does not work, you simply must try something else. This may involve suffering and effort and adjustment for some people.

The fact that some diabetics must be careful of starch does not justify the presumption that carbohydrates as a class are a toxin we can only tolerate, rather than a perfectly legitimate and even necessary energy source we have relied on throughout our evolutionary history.

This is the bright line running through this whole discussion, really.

Are carbohydrates a variably tolerated toxin to the population at large or not?

Years ago I believed these ideas were plausible, but now I would answer in the negative to both of these assertions which form the central dogmas of low carb theology.

Anonymous

I don’t think starch in and of itself is necessarily “toxic” or “dangerous” for people to consume. But for some people, it can unnecessarily elevate their blood sugar and resulting insulin spike beyond what would be considered a “normal” response.

Even people who aren’t necessarily diabetic (like me) have trouble with consuming starchy foods. That’s not to say that others don’t, but it is important to make the distinction or have some sort of simple testing apparatus in place for people to know if a particular starch is “safe” for them or not. I don’t know how “necessary” consuming starch is if it leads to more harm than good. That’s a debatable topic that I’m sure will be bantered about.

Finally, I’m not keen to describing low-carb as a “theology” (although there are some who have a religious, evangelistic fervor in their enthusiasm for it) but rather a movement of people who are attempting to understand how their metabolism works to be optimally healthy. I am in favor of continually trying to educate yourself about what will work for you which is what I seek to do here on my blog.

http://pulse.yahoo.com/_RVQDWKBOFDPLYTBUZERYLQLYRY Ross P

Sorry, but White Rice is NOT a “whole food.” It is a recent, industrially manufactured frankenfood, created for storage and commercial purposes. I’m sure the authors really like it and can’t imagine going without it.

And Austrian physician Dr Wolfgang Lutz published his book Leben Ohne Brot (Life Without Bread) in 1967. At that time many in Germany and the US could not envision living w/o bread, the “staff of life.” But we can and we have.

http://www.facebook.com/profile.php?id=1115202741 Katherine Morrison

The distinction is made multiple times in the book and in the blog. How could it be missed?

The term “safe” starch is used to distinguish tubers and rice from the more problematic grains like wheat. It’s not a comment on the appropriateness of the food for diabetics or others who don’t tolerate them. Some basic common sense would do well here.

But again, this is apparent from reading the original material and not at all from reading your very brief summary.

Elenor Snow

But they’re NOT *safe* for everyone! And while there may be repeated discussion of the intended audience and the limitations that would apply to many people on his blog (which I haven’t time to read) or in the details in his book (which claims a PERFECT health diet) (and except apparently he only means *safe* for the numerically way-fewer people for whom they are safe. A tautology! Doesn’t help me much!), I have not seen this discussed ‘around’ so that I had ever heard of it till this blog entry and discussion.

Jimmy has done a HUGE service to those of us who ‘heard’ of the Jaminet’s concepts and figured, “okay, I can do this; rice is okay.” And it turns out no, I can’t. And probably the vast majority of metabolically deranged can’t. I don’t see much differentiation ‘out in the public sphere’ between those few, and the majority who can’t do “safe” starches. Having all this discussion, which I finally got around to reading, makes clear Jaminet does have a restricted audience in mind for his diet.

http://profiles.google.com/hemoglobina1c Kurt Harris

“Reviewing films is part planning and diagnostics. It is not treatment. This criticism obviously has inflammed Dr. Harris”

What has inflamed Dr. Harris is you presuming to know anything about my career experience of practice, and doing the usual argument from authority all MDs are so woefully prone to. I don’t “review” images, I interpret them. Why the hell are you criticizing my qualifications in an ad hominem fashion when I never mentioned you in my response to Jimmy and I have never had a any contact with you or written anything about you or your theories? Just trying to attract attention, I suppose.

“. I am sorry he is hurt but i am not sorry I said it. Someone had to come out and point out to the lay public that recommendations based upon “predominately reading literature” is not tantamount to providing full scope cancer care and management.”

I am not “hurt”. I am pissed off that I have consulted with over 10,000 patients and you claim to know I dwell in a dark room “reviewing” films. I have not looked at a “film” in over 8 years. No one uses film any more, unless they are doing paleo radiology. Your condescending and belittling attitude toward a neuroradiologist is disgusting and fortunately not shared by the many high caliber well trained neurosurgeons I have worked with in my career.

As if you provide full scope cancer care and treatment? You don’t. You are a neurosurgeon, not an oncologist or an endocrinologist or fat loss researcher. Being a neurosurgeon does not give you one iota more credibility in the realm of diet than anyone else. And where are the oncologists that use diet to treat cancer? There are none…

“A I think any cancer patient can see if my statement here is out of bounds by asking an oncologist if this is correct. Oncologist however do this everyday all day. This is why i metioned the oncologist in my comment.”

Yes, we all know having cancer is what qualifies you to judge peoples ideas about cancer. And I still call bullshit on your claim that your institutions oncologists are all treating cancer with VLC ketogenic diets.

Chris

Its always fun watching narcissists fight it out. Some traits: An exaggerated sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) Shows arrogant, haughty, patronizing, or contemptuous behaviors or attitudes

Thanks for putting this together, Jimmy! I’m constantly tweaking my own diet to figure out what’s best for me – posts like these are very helpful.

Anonymous

Happy to help, Lisa. Information and knowledge is power.

Natalie

I have a bit of a disagreement with Dr. Harris:

“I also have come to see most starchy plant organs as perfectly legitimate fuel sources. ”

Sure, but does it mean they’re optimum?

My reading of the anthropology and ethnology literature, as well as my current understanding of biochemistry and metabolism, lead me to see the human metabolism as a multi-fuel stove, equally capable of burning either glucose or fatty acids at the cellular level depending on the organ, the task and the diet, and equally capable of depending on either animal fats or starches from plants as our dietary fuel source, depending on the biome (biological environment) we find ourselves born in or that we migrate to. We are a highly adaptable species. It is not plausible that carbohydrates as a class of macronutrient are toxic.

Ok, but then he says he says ketogenic diet is not a good idea in the long run (except for some special cases) – why, if they seem to be equal? He also says ketosis is probably stressful – but there’s no hard evidence for that is there? If we’re meant to get energy from carbs, why are there no essential carbohydrates then? Also, what about the glycation issue?

If someone feels best incorporating some starches into their diet – well, I’m happy for them, but that doesn’t mean it’s going to work for other people as a long term solution.

From my own experience, I can’t eat potatoes without gaining a pound or two next day (even after workouts). Even simple sugar doesn’t have the same effect on me. So much for safe starches.

http://profiles.google.com/hemoglobina1c Kurt Harris

The starches and fats are both fuel sources. You are only in ketosis if you are dietarily deficient in carrbohydrate. There is no equivalent state for being short on fat.

Your nearly instantaneous weight loss is almost certainly water. If you are eating VLC and are glycogen deprived and then carb- load, there can be water weight added along with glycogen storage.

Gaining a pound of fat (not water) overnight by eating potatoes would be a gastronomic feat for the Guinness book!

Anonymous

So how long should someone be acclimated to consuming these “safe starches” before tracking what impact they are having on weight/health?

http://profiles.google.com/hemoglobina1c Kurt Harris

To get an honest picture of blood sugar response with a meal, I would allow at least a week of 150 g/day before testing. To assess how your gut feels, a month. If you are VLC it took you time to turn off some switches and adapt, it will take time to turn them all back on again. Of course this advice assumes you are not actually diabetic.

Anonymous

I may test this on myself with the adaptation period.

http://profiles.google.com/hemoglobina1c Kurt Harris

I would suggest boiled sweet or white potatoes or white rice instead of some fat source you are now eating, with about 50g starch at each of 3 meals. If you are going to do this, it would be instructive to do the home OGTT both before and after the adaptation period.

http://www.facebook.com/profile.php?id=100002023989070 Cris Barrows

Anthropology suggests that we evolved our larger brains by consuming newer highly nutrient rich/dense foods – i.e. meat. I would conclude from that that ketones and FFAs became our primary fuel sources and that glucose is only used when we are deficient in fats for fuel, and not the reverse, as your perspective implies.

http://profiles.google.com/hemoglobina1c Kurt Harris

Hi Chris

That is a theory that seems a bit deterministic to me, and I think John Hawks might agree with me. Nevertheless, to advocate eating carbohydrates is not to in any way eschew meat or animal fat. My own diet is only 30% carbohydrate, but also about 50-60% animal fat and I eat grass-fed beef, lamb or fish every day.

So eating 30% carbs instead of 5% or 10% is hardly putting you in Dean Ornish or vegan territory.

“I would conclude from that that ketones and FFAs became our primary fuel sources and that glucose is only used when we are deficient in fats for fuel, and not the reverse, as your perspective implies. :-)”

No, it is the exact opposite. We had a history of getting energy from carbohydrates first on the cellular level. Fatty acids and respiration were later innovations in evolution. As hominids, we originally got most of our energy from sugar or fiber carbohydrate consumed. The later ability to get more energy from dietary fats was added on. Then the ability to eat starch was added on to that and is probably more recent. The humans with the lowest salivary amylase levels still have levels 4x higher than chimps do.

On the cellular level, there is no cell that cannot use glucose, but there are many that cannot use ffas. Use of ketones is highly inefficient. Your kidneys did not even evolve to preserve the precious energy from ketones when you are starving, as they spill out in your urine. So the primary and original cellular fuel for all mammals is glucose, and some of our cells can use ffas. The use of ketones is an adaptation to the nutritional stress of being deprived of glucose, which we will die without. We make ketones TO PRESERVE OUR PRECIOUS GLUCOSE FOR THE BRAIN.

It is not either/or for eating fat or glucose or for using it cellularly. We use both glucose and ffas routinely, and we can eat both carbs and fat routinely so that we don’t have to eat 35% of calories as protein to expensively and inefficiently make our glucose from amino acids.

Dextery

How do you explain Lex Rooker being a total carnivore for the last four years eating a diet composed of 85% fat and 15% protein and zero carbs? He seems to be thriving without safe starches. You know his Dexa Scan is fine. And his lipids are fine. Lex does not appear to be deprived of glucose at all. His ketones are doing just fine.

http://profiles.google.com/hemoglobina1c Kurt Harris

How do you explain people surviving for years on vegan diets, even though it will kill you in the long run? It is not impossible that a person could go from the SAD to meat on water and get healthier, yet meat and water is the not the optimal diet or even a very good one. Look at Danny Roddy’s experience. He was a protege of Lex Rooker and got scurvy…

Anonymous

I’d love to see more thorough research on this subject.

Anonymous

Hey Dr Harriss,

On Lex:

I’m not sure comparing Lex’s diet with my pemmican diet is accurate.I was emulating a dude on the zero-carb forum named Delfuego, who had consumed nothing but pemmican for the last decade. On several occasions Lex told me that it wouldn’t work, and that fresh, raw meat was better. I never listened to him.

On scurvy:

I’m not sure we can say that what I was experiencing was scurvy. I took an ass load of vitamin C for a couple of weeks and my legs didn’t look any different. Eating more food was the cure—I think I was just REALLY malnourished.

It’s not that I don’t want to scare people away from VLCing, because my legs were the least of my problems.

No libido, GAINED weight overtime, looked fucking terrible, apathetic about everything, had no energy to get out of bed, and did I mention no libido? Those were bigger issues that arrose from the joke that is carb restriction.

Uzziah

This man claims he was diagnosed with scurvy (and folate deficiency) after a couple of years on an entirely carnivorous diet. Three months before his diagnosis, he subsisted entirely on homemade pemmican.

I asked Lex about his carnivory and scurvy and this is his response to me:

I spend almost zero time on the forums arguing over diet. What I’m doing seems to be working well for me at this time so I have no reason to look for an alternative. I really don’t want to get dragged into discussions over “Safe Starches” or any other bit of dietary esoterica, as there is no way to tell what is “safe” and what isn’t. Every self proclaimed guru seems to be able to make the case that whatever they’ve chosen to eat is safe, or good, or optimal, or whatever. As for me, the best I can do is say that what I’m currently doing seems to be working but if I start to have problems I’ll change in a heartbeat.

I have dinner with Danny on occasion and he’s never mentioned scurvy to me, but that doesn’t mean much. We usually talk about other things when we get together. One thing I can say is that Danny has never been shy about pointing out both the good and the bad of his dietary adventures on his blog so if he didn’t mention it there then there is a better than even chance that it is just a rumor.

Dr. Harris isn’t the only one that tends to assume that because Danny and I enjoy each others company on occasion, and we often agree in principal on the subject of diet, that Danny, (and others like him), are doing what I’m doing and it is not working for them. This is just not true. Danny has never done what I’m doing. He decided to try his own experiment with eating nothing but pemmican made from dehydrated muscle meat and rendered fat. He and I often discussed that this might lead to problems over the long term, and he did finally terminate the experiment as he wasn’t getting the results he expected. Was scurvy an issue there? I have no idea. All I know is that after eating nothing but pemmican for more than one year, he gave it up because it wasn’t meeting his needs.

In my case, I eat all parts of the animal in the form of Slanker’s pet food. It is very strong tasting and as far as I know there are very few souls brave enough to eat the way that I do. Those that try it don’t last very long as they can’t tolerate the taste. I’ve been eating this way for about 5 years now with no signs of problems. I attribute my success to the pet food – not the fact that I eat zero carb. My own experience shows that when I’m away from home and not able to eat my normal daily mix for an extended period of time, I start seeing signs of problems brewing. When I return to my mix everything goes back to normal.

I also allow my food to sit out at room temperature for several hours before eating it. It becomes rather sour tasting, sometimes with a bit of a fizz to it – especially on very warm days, indicating to me that it is teaming with bacteria. It could well be that the bacteria are producing the vitamins or other nutrients that are in short supply in fresh raw meat. I just know that in paleo times there was no refrigeration and that much of the food we would have eaten would be swarming with bacteria. Who’s to say that rotting meat teaming with bacteria isn’t a vital part of our diet? I have no way of knowing, but it seems to make sense to me so I try my best to emulate what our natural environment would be like without all the modern food preservation techniques.

As you can see, my diet and lifestyle are far from just a simple zero carb, meat-only, diet. My food is a complex mixture of all parts of the animal and the exact make-up of this mixture changes with every order based on what went into the mix at that time. Every order of pet food is different. I also let my food ferment for several hours and sometimes overnight so that it is teaming with bacteria.

When I stop eating this mix and just eat a normal zero carb diet of fresh muscle meats I soon begin to notice little things cropping up, so I return to my tried and true mix and all is well again. I also don’t know of anyone else that eats exactly the way I do, so just because others agree with me in principal, the devil, as always, is in the details. Very few are willing to deal in details. They want a quick magic cure-all that requires little thought and delights their taste buds.

You are free to post this on the forum where the discussion on this topic is taking place. I’ll be posting your question and this reply in my journal as I feel my journal readers would be very interested as well.

Lex

Anonymous

Earlier hominids weren’t hind gut fermenters, getting most of their calories from fatty acids produced in the colon?

http://profiles.google.com/hemoglobina1c Kurt Harris

OK, what are we talking about here, exactly? What to eat or what our bodies do with it? Earlier hominids ate fruits for carbohydrate and got fatty acids from fiber. We evolved from them into an animal that exploits animals for fat when it is available, and when it is not we can make fat in unlimited amount from carbohydrate. We ate enough starch in fact, that increased copies of the amylase gene were selected for, which has no other purpose but to eat starch.

So yes, earlier hominids were hind gut fermenters and we have only retained some of that ability. But I am still not clear what that has to do with what I said, as I said we should eat both starch for glucose and animal fat for fatty acids, and neither to caloric excess.

Are you saying the fact we lost the ability to hind gut ferment for our fatty acids means we no longer need glucose? No, it just means we do not depend as much on fiber for fatty acids.

http://www.facebook.com/profile.php?id=100002023989070 Cris Barrows

Dr Harris,

Thanks for your response – very useful.

Here are my BG results you requested earlier – they are also buried further down in the thread.

BG readings taken every hour starting at zero with a fasting state.10oz Sweet Potato Diced and Sauteed in Butter89, 126, 123, 135, 118, 107, 100…. Pint of Ben and Jerry Choc-chip Cookie Dough99, 145, 111, 115, 84 Eggs (scrambled) and Liver (thinly sliced) Sauteed in Butter88, 82, 87, 86, 89 I’ve done tests using other meats and fats and my BG stays very much in the normal range. My body appears to be producing optimum levels of glucose with no spikes, and no consequent lows and resultant sensations of hunger. A 10oz sweet potato is quite large but during my earlier experiments trying to incorporate more carbs I typically used 2oz portions and ate them with eggs or meats. Using that regime for several weeks did result in a desire to eat more (hunger) and my weight steadily but slowly started to rise as a consequence. Apart from the glucose, a sweet potato has a good nutrition profile, especially Vit A (which I can get from animal sources), but apart from that my question to myself was “why am I eating carbs with a resultant weight gain?” I couldn’t find a good answer in PHD or elsewhere so I stopped and my weight is going down again. I did enjoy eating sweet potato.I hear your perspectives on our abilities to burn various fuels and I do not disagree, I need to research it further, but other experts do disagree with you and I have no meaningful way right now to determine facts from speculation, or who is more right than anyone else. I have positively enjoyed your blog and your seemingly very pragmatic and common sense approach to nutrition, and I will likely always give considerable weight to your views. My discipline is Computer Science so I am out of my depth here by quite a lot.However, while “normal” folk may well deal with starches efficiently, it seems that I cannot do so any longer. My very near brush with full diabetes taught me that my pancreas is likely seriously compromised and I am quite insulin resistant. And all of that is most likely due to decades of high carbohydrate and sugar consumption. It does not appear that I can go back and fix that – I have to live with the result but with a determination to not let my state worsen. I am 59, and my mother is now 95 – she was diagnosed as diabetic when she was 60. I have a 40 year old nephew who has now just been diagnosed as diabetic. It’s in my genes.My critical point here is that I suspect that in these times of obesity and diabetic epidemics there is a large number of people in a similar state that are about to become diabetic or contract one or more of the other related conditions, cancer etc. The neolithic agents of diseases are out there and the unsuspecting and poorly advised majority are going to be unfortunate victims.While you may have valid points concerning ketosis ( I am unsure), and perhaps ketosis is inefficient ( I experience no side effects), that state for me works well for my overall health and ability to lose weight. I suspect many others will also benefit immensely from this condition, even if it is inefficient. For those who are metabolically challenged like myself I suspect this is by far the best option we have for a healthy life.I would suggest that for this subgroup of the population, which is likely to grow for sometime, starches of all types need to be strictly avoided. My typical regimen: No breakfast (don’t feel hungry in the mornings), egg and steak (or liver, kidneys, heart) for lunch (about 6 oz total), and something similar for dinner. I snack on tinned salmon. I drink water, and chicken stock. I don’t like tea or coffee. I sometimes get a craving for something sweet so I take a walk to the corner store and buy a small bottle of diet coke. I lightly cook most things in butter and tallow sometimes. I make my own tallow and I sometimes make jerky and pemican. I supplement with magnesium and a quality probiotic. Hope this personal view is of some value.Cris

http://profiles.google.com/hemoglobina1c Kurt Harris

Thanks for the details. If VLC is working for you, it’s hard for me to argue against it. It worked fine for me, but eating moderate carbs now works better. I doubt if you are permanently damaged. You are eating a very low-reward diet. If you swapped out some meat for unseasoned white potatoes with each meal I doubt you would gain fat.

http://www.facebook.com/profile.php?id=100002023989070 Cris Barrows

That’s worth another experiment. I need a couple of weeks to get a steady state VLC again then I’ll give that a try. I’m curious to see which of all you ‘experts’ are right? Thanks.

http://profiles.google.com/hemoglobina1c Kurt Harris

Well Chris, unfortunately you will have to decide which “experts” are correct before your experiment, the ones who have apparently not read the literature on what constitutes normal blood glucose physiology, or the ones who are claiming that any blood glucose rise after your breakfast is pathology. Otherwise, your “experiment” is determined to fail by definition.

When a guru decides that any and all glucose and insulin are the devil, by definition their presence will be a “failure”….

Anonymous

How high should BG or insulin go before it is considered harmful?

http://www.facebook.com/profile.php?id=100002023989070 Cris Barrows

Haha – I am not entirely inexperienced at assessing “experts”. I directed an R/D department for a major computer maker for 10 years – it is not so difficult to spot poor conclusions and incomplete or inadequate analysis. My frustration in this current debate is my near total absence of background knowledge of the field, but even so it is not so difficult to spot poor science and questionable conclusions. I can spot a poor process even when I don’t know the correct answers. In PHD a great deal of the content appeared very authoritative and well argued, yet I still could not discern how much was real science and how much was well intentioned, well informed, but rationalized speculation. In this field, unlike computing, there is a significant absence of high quality instrumentation that would enable clear true deterministic conclusions. Much of what I see here appears more in the way of inductive reasoning based on inadequate data – hence the significant debate and disagreements between experts working the same field. The poor lay-person like myself has little chance to make truly informed decisions.

As for the BG results: I’ve seen enough to expect a rise in BG after a meal, what I hadn’t measured before was the effect of such a starch – I hadn’t eaten any for many years. It was 6 hours and my BG had still not returned to normal. To my mind that is a long time with an elevated BG level. If I am allowed to assume that sustained high levels of BG become toxic to the system (i.e. a diabetic effect) then such a polysacharride that continues to pump glucose into my bloodstream for 6+ hours at a level some 40% above normal, feels intuitively destructive. Especially when compared to the protein/diet meal that caused no glucose level change. Hence my concern over the idea that starches should ever be classified as safe, whether they contain fructose or not.

Now the question I need answered is what is the greater danger – potential toxic effects of sustained high levels of BG or the effects of ketones and their production that you have raised as a potential danger. In the 7 something years I have spent experimenting with LC I have become very wary of anything that raises BG. The past 50 years of high carb regimens has shown a clear correlation between high carb consumption and modern diseases, and I believe that is not disputed here. Do we need to go all the way into full ketosis for optimum avoidance of glucose, or not? You have argued that we should take sufficient carbs to just stay outside of ketosis, others disagree strongly. My problem now is how do I proceed to assess the science and claims of the two approaches.

Cris

GalinaL

Dear Dr. Kurt Harris, could you tell me which BG readings do you consider to be reasonable? I am sure , if somebody adapted to VLC decides to consume 150 gram of carbs a day in order to be prepared for the glucose tolerance test, the blood sugar reading most definitely would increase 140 mg/dL . Is it damaging for one’s health? Is it wise to do some adjustments (eat small portions of carbs frequently, consume carbs without meat or with fat, or something I can’t think of), or 3 days of out-of-line BS is not a big deal? Which level of fasting BS for the person with peripheral IR do you consider to be appropriate? Thank you for the participation in the discussion. I follow very close you diet advise with LC twist.

http://profiles.google.com/hemoglobina1c Kurt Harris

I don’t want to give you precise numbers. The point is that whatever they are, they will be much higher if you test yourself while you are on VLC – not carb adapted.

So you cannot claim to be abnormal by testing your pp BG with carbs if you habitually do not eat them.When I was VLC, eating 100g starch as white potatoes for a home OGTT could get my BG as high as 155 at 45 minutes and then it went down to about 115 at 2 hours. My fasting BG was 86. I weighed 150 at 5′ 11” at the time. I have no history of IR, met syn, diabetes, etc. My maximum overweight was 20 lbs. Once you are carb adapted, a fasting BG in the sub 90 range, preferably low 80’s or upper 70′ is good. PP BG readings after meal are highly variable and depend on the meal, but “spikes” in the 120s with carbohydrates are not pathologic in normal people as long as the BG does not stay there for many hours. I have seen non-diabetic people spike their BG from the 80s to the 110s just with exercise from the epinephrine. The point is that defining all BG rises as pathology to be avoided is superstition.

Anonymous

Can you define what you consider “working” with a diet?

http://profiles.google.com/hemoglobina1c Kurt Harris

You lost all the fat you needed to and are now at an optimal fat mass, and you are not yet having any side effects of severe carbohydrate restriction.

Some people do. In addition to stalled fat loss because they have found newly rewarding concoctions or treats to eat, some folks have symptoms of hypothyroidism or deficiencies of magnesium and many have constipation, decreased exercise or work tolerance, etc., etc.,

Anonymous

Blood sugar spikes will happen with consuming starch because it turns into glucose in the body. But PJ can chime in.

Anonymous

I hear ya, Melissa. And I too have read Paul’s book and happily had him on my podcast to talk about his concepts. But this was intended to be more about the concept of “safe starches” and less on the personalities behind it. I agree if they were responding to the book after reading it that actually reading the book would have been in order. That’s not what I asked them to do. Hopefully I’ve now put the Jaminet’s work on their radar screen so they can investigate it further. And I too prefer a respectful, polite and productive discussion and debate (although you can tell from the comments to this post that doesn’t happen as easily in the blogosphere).

http://www.aworldlymonk.com Sam Knox

The way things are going, the next Ancestral Health Symposium could be held in a phone booth.

Jeff Kiefer

Or boxing ring….

Nina

Jimmy this is one of your all time best pieces of work. What a balanced discussion.

I find it interesting to see the responses and those who go for the knee jerk – ‘this is total crap’ and those who discuss the pros and cons and INDIVIDUAL responses to diet. Well done and thank you.Nina

Anonymous

THANKS Nina! Tried to leave no stone unturned on this.

Bill

Jimmy, you are a very naughty boy. You should have at least made sure the commentators had read THE BOOK, and if not sent them a copy first. At lot of them ended up talking out of the back of their heads for that very reason!

Anonymous

Again, my question was merely about “safe starches” as a concept, not Jaminet’s book.

http://twitter.com/chrishighcock Chris Highcock

But their book defines “safe starch”

Anonymous

I know it does. But it’s the term being used in the blogosphere that is confusing people Chris. People need to get the book…or Paul could put it clearly on his site.

Jmercantini

I think we need to use common sense here, if you know safe starches raise your blood sugar, just don’t eat them.

Anonymous

Their claim is that blood sugar rising isn’t the whole story.

http://hanksjourney.com Hank Garner

Just thought I would weigh in with my experience with starches. After dropping around 120 pounds, I plateaued and noticed I was having some issues with performance when running. I had been taking in only around 20-30 grams of carbs a day for over 6 months. I started adding in some “safe starches” like sweet potato and brown rice as well as fruit like berries, peaches, pineapple, mango, bananas and nectarines. After an initial weight gain of around 5 pounds ( I assume from replenishing glycogen stores), I started dropping weight again and am leaner now than ever. I am not diabetic, so this may be fine for me. I think the key for me is staying with “real food” and the added starch and fructose doesn’t seem to bother me at all. I guess the discussion about “safe starches” is like everything else. You MUST test for yourself.

Anonymous

Awesome! Thanks for sharing your experience and research Kurt.

http://www.facebook.com/profile.php?id=100002023989070 Cris Barrows

I have been experimenting with weight loss methods and various potential healthy nutrition ideas for the past 35 years, from high-fiber, food combining, SAD, to vegetarian, to vegan, to low-carb, and zero carb. Diabetes is a strong family trait – I intend to avoid it and zero carb or near zero carb feels like an optimum approach for my particular body type. I.e. I have never felt quite as good as this since perhaps my teenage years, and then I’m not so sure about that. I have been LC and VLC now since 2004 and I cannot yet see any good reason to change from that lifestyle.

I don’t want to adapt to “safe starches” because I don’t see any reason to include them, or any carbohydrate. The argument postulating glucose deficiency was not convincing. My improved mental alertness that appears to come from keto-adaptation feels quite optimal. Also, the way that needed glucose is produced through gluconeogenesis via glycerol or amino acid conversion is quite elegant. Instead of me trying to second guess what my body needs in terms of the correct glucose dosage via carbs, my body can figure it out by itself. Whether I should consume 20g carbs, or 100, or 200, or 400, seems to be an unnatural process and apparently unnessessary.

From the many books, blogs, and papers I have read – in total – excess glucose always tends to be the most damaging to overall health – glycation, inflamation, A1c, etc. Intuitively from all my experiences so far, a concerted effort to minimalize glucose feels like an optimum approach.

We really don’t know how much our paleolithic ancestors really consumed in terms of macro-nutrients – we are guessing and trying to rationalize. They did survive the last ice-age where carbohydrates would have been significantly scarce, but that might just mean that we are very adaptable. My target is longevity, in the spirit of Ray Kurzweil’s “live long enough to live forever”, so I will likely to continue to refine my dietary habits as new knowledge becomes available. But this entire debate on “safe starches”, at least for me, seems to say they are optional, and as a minimalist I conclude – therefore unnecessary. Cris

http://www.aworldlymonk.com Sam Knox

“…my body can figure it out for itself.”

This is an excellent point, and seldom discussed.

One of the underpinnings of the “carbohydrate-theory” of obesity is the idea of “homeostasis”. In the absence of excess carbohydrate, appetite is self-regulating. (Although what constitutes an excess might be a matter of trial and error.)

http://www.facebook.com/profile.php?id=100002023989070 Cris Barrows

I have to admit there is a lot of good information here and I discovered some new bloggers I didn’t know existed who seem quite excellent – Zoë Harcombe, for example. A fellow Brit as well.

Thanks Jimmy for the thread.

Praxisworks

As a consumer of diet advice, I was eager to read this discussion. But I was mislead to its true purpose. I thought it was designed as a platform for experts to weigh in on their collective understanding regarding the role of starch in the human diet. Instead, it seemed designed to discredit the Jaminets (let alone their ideas), and for many in the low carb community to further their positions. I read Perfect Health Diet (which I wish I could say were true of everyone who responded), and, indeed, their starch/carbohydrate theory is provocative within the context of this discussion, no question about it. But their argument is sophisticated and compelling and does have interesting implications. I urge anyone who hasn’t read the book to do so. I hope the conversation moving forward will yield solid and important information that will further the field. But this would require a willingness to graciously suspend beliefs and to admit to gaps in understanding, knowledge, and letting go of entrenched positions (not to mention some discipline in regard to civility and language). Perhaps this discussion signals a need for a more effective forum, much like the recent AHS, but through an on-line format. I personally would like to see it framed around the variability in human nutritional needs and conditions, instead of the usual, tired, Cartesian, formulaic, one-size-fits-all theories, low carb included. But that would take courage and vision. Anyone up for the challenge?

Anonymous

I agree the sides can get so dogmatic that it’s difficult to understand. But my purpose in writing this was to share what various experts think of the role of “safe starches” in the diet. That’s exactly what happened. There was no requirement to read the book since it was not about Paul but rather his concept. I do agree people should read the book before making any comments about the Jaminet’s plan.

jethro bodine

Great discussion but I have a problem: Nobody has addressed the fact that during the 30,000 years of the ice age, humans survived and thrived on a very low carb (if any) diet.

http://weightmaven.org Beth@WeightMaven

So that means more than the other 2,570,000 years of the paleolithic age?

comrade_stalin

It means that your “carbs are necessary lo live” theory is fool of holes, and you cannot provide an adequate response other than answering my question with a question.

try again!

Anonymous

Nope, looks like we got it right the first time.

Haggus Lividus

I’d like to add some more details about the test I ran on myself as I’ve read that some think I might not be carb sensitive even to make it relevant.

First and foremost, I had the date marked down wrong. I performed the test some 3 days ago, not last month. The correct date is 051011.

By chance, from Sept 4 to Oct 4/2011, my average carb intake was 194.4g (it wasn’t just the rice I tested on myself), and my BG averaged 5.0mmol/L.

Also, in case anyone is wondering, I didn’t label myself IGT, my doctor did after my OGTT test. He also called it metabolic syndrome X for whatever that’s worth. My numbers on that day were 6.9mmol/L for my fasting BG, 6.8% for my a1c and I pulled an 11.0mmol/L two hours in.

Finally, it wasn’t out of petty malice that I dropped some bloggers from my must read list, it’s that I felt left out.

http://www.facebook.com/profile.php?id=1506613581 Yvonne Mitchell

Unless you have Fibromyalgia and the effort of blow-drying your hair brings on severe muscle fatigue and cramps.

Anonymous

Never called myself a journalist and never have. But I do report information to my readers through my blog. I make no bones about being enthusiastic about low-carb, but I’m open to people finding what works for them.

Anonymous

Thanks Donald

Stan Pinsky

Thanks Jimmy for starting this conversation. I would have to say it was disappointing that many of the experts put almost no effort into familiarizing themselves with the Jaminets work. Their comments seem to reflect that.

To the “Anonymous Prominent Member of the Low-carb Community” I will paraphrase SNL – If you’re not a clinician your crap. Really? Do you suggest we disregard good book learn’n folks like Taubes, Wolf, Guyenet, Cordain, Sisson, etc?

http://pulse.yahoo.com/_AW5VJ3O36DLBMIMZ5DQPS6ZGLQ Keith

I’m a month late to this party, so this comment might go unnoticed, but I want to jump in anyway, in case it helps.

I’m not a biochemist or nutritionist — I’ve just read a bit about these subjects in an attempt to improve my health, and some of what I read seems to contradict the above claim that whatever the body’s need of glucose (I won’t argue the exact amount), if you don’t consume that amount daily as carbs, your body has to make it from protein. I understand that most people think that forcing the body to make glucose from protein is undesirable for several reasons, so I understand why that is to be avoided. But what I have read, from Rosedale, at least (I don’t remember whether I’ve seen it elsewhere), is that when the body is in fat burning mode, it makes glucose from the byproducts of fat burning, not from protein.

So it seems to me that if one is eating very low carbs, so that the body switches to fat burning mode, it preferentially makes whatever amount of glucose it needs from the byproducts of fat burning, not from protein. This seems like an ideal arrangement, unless there are undesirable effects of operating in fat burning mode. I believe Rosedale believes that fat burning mode is the mode that causes the least undesirable effects in the body. Do others disagree with that on solid grounds (not misguided fears of ketoacidosis)?

I have to admit that I’m a bit confused by the apparent claims that the body freely mixes glucose burning and fat burning. From what I’ve learned from Rosedale, it takes those body cells that can burn fats a few weeks to switch from glucose burning to fat burning (but can switch back to carb burning almost instantly), so if one’s diet does not constantly maintain a low enough level of carbs to keep the bulk of the body in fat burning mode, it will keep slipping into carb burning mode again, and take a while to get back to fat burning. It seems to me that if that switching of modes happens a lot, then when the carb intake is low, the body might not have yet switched back to fat burning and so won’t have the byproducts to use to make up the glucose deficit and so would be forced to convert protein to glucose. Could this be why you are saying that the glucose comes from protein? Because in those people who don’t diligently maintain the fat burning mode, they *are* forced to convert protein?

So it seems to me this would happen only in people who try either to go low carb only intermittently, or who try to mix a moderate amount of carbs into an otherwise high fat diet. Maybe it is those practices that are the problem, not the practice of diligently maintaining a constant low carb diet. What do you think about that?

My understanding is that fat cannot be converted into glucose, however, fat is stored and transported in the form of triglycerides. These are are a combination of 3 fatty acid molecules (the real fats), and 1 glycerol molecule. When the fats are used for energy the molecule is broken down into its four separate parts, the free fatty acids are then used for energy leaving the glycerol molecule that can be converted into glucose. One argument is that the amount of glucose produced by this method isn’t necessarily sufficient to meet all the needs and that some glucose must come from elsewhere, from either carbs, or from protein.

As I understand Ireland’s Palaeolithic diet it included – Acorn, Cat tail, burdock, arrowhead root, not to mention wild berries. It’s quite possible that they were in ketosis all winter but I certainly don’t imagine they avoided starchy roots when they could get them.